Strategy Appendix

Action Item Number Action Item Name Action Item Description Lead Agencysort icon Component(s)

1.3.A

Support Substance Abuse Prevention on College Campuses

Since the largest drug-using population is among 18- to 25-year-olds, it is vital that prevention efforts do not stop after secondary school education.

Read more
The Departments of Health and Human Services and Education have long been active in the area of drug prevention among the college population (especially high-risk drinking) through entities like the Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention, the Centers for Disease Control and Prevention’s College Health and Safety initiative, and other grant programs. These and other efforts will continue, and will augment work by private foundations and nongovernmental organizations that have long shown leadership in promoting health and safety on college campuses by disseminating information on model campus-based programs.

DEd ---

5.2.C

Develop National Plan for Southbound Interdiction of Currency and Weapons

The enormous amount of money generated by drug sales in the United States fuels the expansion of violent drug-trafficking organizations.

Read more
Similarly, the weapons acquired by traffickers also enable them to wreak havoc within Mexico and the United States. The Southwest Border Strategy strongly endorsed an intensified focus on the south-bound threat. CBP is working to renovate south-bound point-of-exit lanes to allow for increased inspection and is hiring personnel specifically for the south-bound mission. DEA is building, in collaboration with other Federal agencies and State and local partners, a network of automated license plate readers to identify likely currency and weapons smugglers. This effort requires close cooperation with local authorities, both to facilitate installation of the cameras and to ensure the information is acted on appropriately. Treasury’s Office of Foreign Assets Control (OFAC) is pursuing the use of Kingpin Act civil and criminal penalties against United States citizens supplying or selling arms to the cartels and also is exploring applying penalties to bulk cash smugglers. It is also aiming at designations of those receiving arms and bulk cash for the traffickers on the Mexican end of the supply chain. DHS, DOJ, and partner agencies will develop an interagency national concept plan in 2010 for a south-bound interdiction system and ensure sharing of data among systems tracking weapons, currency, and narcotics trafficking to promote effective targeting of operations and vital de-confliction of investigations. This effort will include utilization of the resources and capabilities of State, local, and tribal law enforcement agencies.

DHS CBP

5.2.D

Coordinate Efforts To Secure the Northern Border Against Drug-Related Threats

The southwest border is a major focus of drug policy, but there are also considerable challenges on the northern border.

Read more
MDMA/Ecstasy, marijuana, and methamphetamine are trafficked from Canada into the United States, while cocaine, bulk currency, and weapons are trafficked from the United States into Canada. Gang members, traffickers, and couriers move back and forth between both countries. The scale of synthetic drug-trafficking across the United States-Canada border is a serious concern for both governments. According to the 2010 National Drug Threat Assessment, the amount of MDMA seized at or between northern border ports of entry (POEs) increased 594 percent (from 312,389 to 2,167,238 dosage units) from 2004 to 2009. The United States benefits from a close, longstanding, and productive working relationship with Canadian law enforcement agencies. Canadian authorities and United States law enforcement agencies are already partnering through Integrated Border Enforcement Teams (IBETs) which identify, investigate, and interdict persons and organizations that pose a security threat or are engaged in other organized criminal activity. DHS leads United States participation in the IBETs, partnering with the Royal Canadian Mounted Police and the Canada Border Services Agency. These operations are vital and must be continued. United States agencies operating on the northern border will ensure that the necessary personnel, equipment, and technology are placed on or near the northern border and that information on threats and operations is shared both among all Federal agencies operating in the area and with State, local, and tribal partners in the region.

DHS CBP

5.2.E

Deny Use of Ports of Entry and Routes of Ingress and Egress Between the Ports

This Strategy and previous Executive Branch efforts have focused on the vulnerabilities of our southwestern and northern land borders.

Read more
As additional personnel, technology, and infrastructure are deployed to the land border, the threat to our air and maritime borders may increase. Air and maritime ports represent a unique challenge with regard to drug-related threats, considering the large volume of cargo and personnel that move through these ports each day. Traffickers have long sought to exploit this vulnerability, and intensified control efforts by United States agencies are necessary. Especially in the jurisdictions near our POEs, State, local, and tribal law enforcement and fusion centers should be provided with regularly updated information on smuggling/concealment methods and techniques. DHS will develop plans in 2010 to better control drug smuggling through these ports and engage with State, local, and tribal partners to improve current outcomes, particularly with respect to activity that may take place between the ports.

DHS CBP

5.2.F

Disrupt Surveillance Operations of Drug-Trafficking Organizations

Disrupt Surveillance Operations of Drug-Trafficking Organization(s)(DTO): Drug traffickers dedicate significant resources to monitor enforcement operations of United States agencies.

Read more
On the southwest border, for example, they employ large numbers of strategically placed “spotters” or lookouts, who closely observe activities of CBP officers, canine teams and enforcement operations to provide intelligence to DTO(s). In the drug Transit Zone, there are similar occurrences with the usage of small recreational vessels and fishing vessels as lookouts for DTOs attempting to smuggle contraband passed through U.S. and partner nation air and maritime assets. The information gathered by DTO surveillance is used to determine the most opportune time and location to attempt illicit activities including drug smuggling operations. DTO(s) also are using advanced technology to intercept law enforcement communications. Systematic efforts to attack and disrupt these deliberate counter-enforcement capabilities are constantly being explored and implemented.

DHS CBP

5.3.G

Develop National Parcel Post Initiative

There is little doubt that a significant amount of illegal drugs moves through our public and private mail systems.

Read more
This is a particular problem with prescription drugs, which are easily mixed in with large-scale legitimate mailings. Considering the huge volume of packages, domestic and international, that are transited throughout the 50 States, this threat poses a difficult challenge and overwhelms the limited manpower now focused on examining these packages. Nonetheless, new technologies combined with investigatory efforts hold promise to curtail this problem. The HIDTA program currently funds some parcel post operations that have netted numerous seizures across the country. One obstacle with this project is the coordination needed for these types of investigations. Federal agencies need to support State and local agencies with these types of investigations, given the multijurisdictional boundaries involved for State and local partners. DHS will partner with HIDTA and DEA in 2010 to develop a new initiative to first analyze how this challenge can best be met on a national scale and then to launch pilot initiatives at several locations.

DHS CBP

6.3.B

Disrupt Illicit Drug Trafficking in the Transit Zone

The Joint Interagency Task Force South (JIATFS), a DOD component of U.S. Southern Command, coordinates and directs detection and monitoring of all illicit drug-trafficking activities in the Transit Zone.

Read more
Bringing together partners from the military, law enforcement, and intelligence communities, along with our international allies, JIATFS has contributed to impressive interdiction results and disruptions of trafficking organizations by United States law enforcement agencies and our international partners, allowing us to “work smarter.” This has largely been accomplished through the consistent employment of Maritime Bilateral Counter-Drug Agreements and Operational Procedures, improvements in the exchange of information among our partners, better detection technology, development of more and better actionable intelligence, and improvements in the ability of transit zone partner countries to conduct interdiction endgame operations on their own. Our law enforcement agencies must continue to develop technology, tactics, and procedures to combat evolving smuggling trends in order to improve our interdiction capabilities. Achievement of the national interdiction goal—removal of 40 percent of all documented movement of cocaine through the Transit Zone by 2015—will rely on continued refinement of every facet of the interdiction continuum. If this goal proves not to be attainable even with those improvements, it will be evaluated to determine whether the goal is realistic or should be revised in light of the limits of interdiction.

DHS USCG

2.1.D

Identify and Make Available Additional Training in Evidence-based Practices for Substance Use Disorder Assessment and Care to Healthcare Professionals Providing Care to Military Health System Beneficiaries

DOD will identify and make available additional training in evidence-based practices for substance use disorder assessment and care to healthcare professionals providing care to Military Health System beneficiaries.

Read more
Additional training integrated into existing professional training and available online will make it more likely that providers can identify substance use disorders when present and can institute or refer for further care based on evidence-based principles.

DOD ---

1.4.B

Enable Law Enforcement Officers To Participate in Community Prevention Programs in Schools, Community Coalitions, Civic Organizations, and Faith-Based Organizations

Federal, State, local, and tribal law enforcement officers have valuable knowledge, experience, and energy to contribute to community prevention efforts.

Read more
Law enforcement officers, especially when seen outside of law enforcement settings, are uniquely able to garner the attention of youth. This investment of their time working on prevention has tremendous potential to reduce drug use and crime. Federal agencies will explicitly encourage their own personnel and federally supported task force officers to participate in drug prevention campaigns in conjunction with local organizations and coalitions. To increase the involvement of HIDTA law enforcement personnel in drug prevention, ONDCP allocated $800,000 of FY 2009 discretionary funding among 18 HIDTAs for prevention initiatives, resulting in the creation of 15 new initiatives and the expansion of 3 existing ones. Those HIDTA-funded prevention initiatives are tailored to the specific needs of each community served and expand evidence-based prevention programs for at-risk youth. In addition, as part of DEA’s Demand Reduction Program, special agents in every DEA Field Division work with their communities to provide in-house expertise on the illegal use of substances ranging from prescription drugs to heroin. DEA is uniquely suited to providing direct information and support to community coalitions.

DOJ ---

2.2.B

Expand Prescription Drug Monitoring Programs and Promote Links Among State Systems

States that have developed prescription drug monitoring programs—either on their own or with Federal support—have tended to follow one of two approaches.

Read more
  Some monitoring systems are more oriented toward criminal justice purposes (e.g., arresting individuals operating “pill mills” under the guise of pain clinics), whereas others are tailored more to clinical care purposes (e.g., preventing adverse medication interactions).  ONDCP will convene interested agencies and State prescription drug monitoring program officials (HHS, DOJ/DEA; American Medical Association, American Pharmacists Association) to develop a harmonized version that combines the best features of both approaches.  The goal is to have one system that can be easily used by all parties and will maintain appropriate confidentiality safeguards for patients.  Once a standardized and compatible system is designed, database specifications will be codified using American Society for Automation in Pharmacy standards for electronic prescription formatting.

DOJ DEA

2.2.C

Increase Prescription Return/Take-Back and Disposal Programs

The family medicine cabinet is increasingly a source of drugs that are abused (e.g., the pain pill prescription that was never finished, the tranquilizers that are used occasionally).

Read more
Yet disposing of such medications in a fashion that is simple, legal, and environmentally responsible is a challenge. In some communities, law enforcement professionals and grassroots organizations have held “take-back days” in which such medications are safely collected. At the Federal level, DEA is making efforts through legislative proposals to facilitate the establishment of prescription-controlled substance take-back programs around the country. These grassroots and legislative efforts will be intensified as part of the Administration’s effort to combat prescription drug abuse, and the private sector (e.g., community drugstores) will be engaged as a potential partner in take-back programs. These efforts will also be complemented by activities of several other Federal partners, including the work done by FDA to educate patients and family members on the most appropriate methods of disposal for these products when take-back programs are not available.

DOJ DEA

2.2.D

Assist States To Address Doctor Shopping and Pill Mills

Criminal organizations have established a thriving business of transporting individuals from parts of the country with strong prescription-monitoring programs to less well-monitored areas populated by “pill mills” that distribute prescriptions indiscriminately.

Read more
This is an extremely difficult problem for state-level law enforcement to handle, due to resource constraints and difficulties navigating cases across multiple State, local, and tribal jurisdictions. It also creates significant problems for prescribers trying to determine whether a patient is doctor shopping. HIDTAs and DEA continue to work with State, local, and tribal officials to suppress this aspect of the drug trade through training provided by the National Methamphetamine and Pharmaceuticals Initiative and DEA’s Tactical Diversion Squads.

DOJ DEA

2.2.E

Drive Illegal Internet Pharmacies Out of Business

Proper and safe prescribing of medications rests on a triangle of responsibility comprising the patient, the prescriber, and the pharmacist.

Read more
Some but not all Internet pharmacies live up to their part of this responsibility. Internet pharmacies that sell prescription pharmaceuticals without a valid prescription and/or personal contact between a patient and a physician are a threat to public health and a source of significant criminal revenue. The 2008 Ryan Haight Online Pharmacy Consumer Protection Act requires all Internet pharmacies that exceed the thresholds set by the Act to obtain a special registration from and report monthly to DEA, to disclose detailed information on their home page, and to provide no pharmaceuticals to individuals who have not had at least one face-to-face evaluation by a prescribing medical practitioner. These increased controls have already had a significant impact on reducing the number of illegal Internet pharmacies. DEA will continue to partner with international, State, and local law enforcement agencies to further suppress these sources of prescription drug diversion and abuse.

DOJ DEA

2.2.F

Crack Down on Rogue Pain Clinics That Do Not Follow Appropriate Prescription Practices

Through enforcement actions and the Ryan Haight Act, many of the domestic illegal Internet pharmacies identified through DEA-led investigations have been shut down.

Read more
What has emerged, however, is the proliferation of establishments involved with pain management outside the scope of acceptable medical practices. Currently, these “rogue pain clinics” are now a major source of controlled substance pharmaceuticals for drug seekers. Although pain clinics are operating throughout the United States, DEA has identified three major hubs where these illegal schemes are flourishing: the Houston, TX, area; the Los Angeles, CA, area; and, most significantly, the tri-county area of South Florida (Palm Beach, Broward, and Miami-Dade counties). The vast majority of patients that visit these clinics come from out of state. The opiate-based pharmaceutical controlled substances most frequently illegally dispensed at the clinics in the Texas and California regions is a combination of hydrocodone and alprazolam (Xanax®). In the South Florida region, oxycodone products are most frequently dispensed. DEA, in coordination with other Federal, State, and local agencies, will investigate these rogue clinics through expanded Tactical Diversion Squads and will shut down, via administrative actions, those DEA registrants in violation of safe prescribing practices.

DOJ DEA

4.1.A

Organize Communitywide Efforts to Reduce Open-Air Drug Markets and Gang Activity Via Drug Market Intervention Approaches

In the past decade, numerous communities have taken a stand to stop open-air drug markets, not by making mass arrests, but rather by implementing powerful, positive, restorative justice techniques.

Read more
One such approach is the emerging Drug Market Intervention (DMI) approach. Participating neighborhoods had been targeted with traditional drug enforcement methods that produced short-lived positive gains. Many of these communities, fed up with a seemingly never-ending cycle of drug dealing and violence, followed a new multipronged operational plan, piloted in High Point, NC, that addressed individual geographic drug markets, directly engaged drug dealers and their families, created clear and predictable sanctions, offered a range of community services and help, and, perhaps most important, mobilized community and offender standards about right and wrong. Jurisdictions that have successfully implemented this strategy include Chicago, IL; Durham, NC; Milwaukee, WI; Nashville, TN; Nassau County, NY; New Haven, CT; Ocala, FL; Providence, RI; Raleigh, SC; and Rockford, IL. Several other cities are in the process of evaluating initial results. Training on the DMI has taken place in High Point, NC; Milwaukee, WI; Nashville, TN; and Tampa, FL. The Department of Justice is in the process of replicating and evaluating these efforts elsewhere, and reviewing and funding DMI efforts will remain a priority area for exploration.

DOJ OJP

4.1.C

Support Innovative Criminal Justice Research Programs

The Obama Administration is committed to enhancing Federal efforts to study promising drug enforcement initiatives, identifying the elements that enable these initiatives to have a positive and sustained impact, and sharing these best practices with communities throughout the country.

Read more
The Office of Justice Program’s (OJP’s) consolidated initiative to support social science research on crime and justice will build on the National Institute of Justice’s (NIJ’s) extensive work in this area. Past examples include the following programs: Managing Criminal Investigations, Children at Risk, and Breaking the Drug-Crime Cycles. The purpose of this initiative is to advance justice by gaining knowledge about what works in criminal justice programs and policies and what makes communities safer from crime. This new research initiative will support a robust research program administered by OJP’s National Institute of Justice (NIJ). NIDA also supports the Criminal Justice-Drug Abuse Treatment Studies (CJ-DATS) Initiative, a multisite research collaborative to develop and test evidence-based approaches for treating drug use and related conditions in the criminal offender population. Now in its second phase, this expanded initiative will test implementation strategies to foster treatment adoption and promote continuing care.

DOJ OJP

4.2.A

Enhance and Promote Diversion Strategies

Some jurisdictions have allowed offenders with a drug use disorder, upon arrest, to be immediately diverted to alternative programs.

Read more
Front-end efforts that direct individuals with substance abuse disorders to community-based treatment have proven promising in better treating behavioral health disorders and reducing the likelihood of recidivism. Diversion initiatives have expanded greatly over the past decade and include a variety of programs at all points of the system: prebooking, postbooking, court-based, deferred prosecution, and even those focused on special populations such as women with children. The Department of Justice will continue to monitor the development of diversion strategies at all levels of government and will provide enhanced Federal assistance and best practices information to promote the use of the most effective interventions.

DOJ OJP

4.2.B

Support Drug and Other Problem-Solving Courts

In recognition of the links between substance use and crime, substance abuse treatment for offenders has been part of the National Drug Control Strategy for many years as a combined effort to reduce threats to both public health and public safety.

Read more
One widely researched and adopted example of this combined approach is the drug court model, which promotes collaboration among the judiciary, community corrections agencies, drug treatment providers, and other community support groups in order to meet the public health and safety needs of both the community and the drug-involved offenders. Many evaluations have shown these courts are cost-effective alternatives to traditional incarceration, and can simultaneously prevent many offenders from committing new crimes and from returning to drug use. Drug courts should now concentrate efforts on how to increase their impact on prison-bound offenders, focusing on offenders at the highest risk for continuing substance abuse and criminal activity. In addition to drug courts, community courts are another type of problem-solving court and can effectively serve the needs of lower-level drug-using offenders. Community courts are neighborhood-focused courts that address local problems, including drug possession, shoplifting, vandalism, and assault, most of which are misdemeanor offenses. Like drug courts, community courts link addicted offenders to judicially monitored drug treatment, but they are unique in that they make use of a broader array of mandates (including job training and community restitution).  These courts strive to create new relationships with neighborhood stakeholders such as residents, merchants, churches, and schools, and they test new and aggressive approaches to public safety, rather than only responding to crime after it has occurred. The Administration supports locally driven drug and community courts and will continue to identify ways to ensure the appropriate court is matched with the right offenders.

DOJ OJP

4.2.C

Promote TASC Model of Intensive Case Management

Treatment Alternatives for Safe Communities (TASC) offers a state-level model for how intensive case management of drug offenders might work to reduce crime and incarceration and support reentry programs.

Read more
In many states and localities, governments have provided access to treatment as an alternative to prison for nonviolent offenders with substance abuse or dependence disorders. If clients meet eligibility criteria under the statute, TASC conducts an indepth assessment of their criminal justice history, the nature and extent of addiction, readiness for treatment, and likelihood of treatment success. Through a specialized system of clinical case management, TASC initiates and motivates positive behavior change and long-term recovery for individuals in criminal justice, corrections, juvenile justice, child welfare, and public aid systems. TASC case managers develop individualized service plans that include links to community-based substance abuse treatment, medical/mental health services, vocational/educational programs, and other needed social services. This approach has translated into substantial cost-savings through referrals to treatment and services. States should look to places that have effectively implemented the TASC process, such as Illinois and New York, and the Department of Justice will continue to fund alternatives to incarceration so that TASC and TASC-like processes can work effectively.

DOJ OJP

4.2.D

Foster Equitable Drug Sentencing [COMPLETE]

In the 1980s, as crack-cocaine markets were causing considerable damage to communities throughout the United States, Congress passed legislation mandating minimum sentences of 5 years in prison for persons trafficking in 5 grams of crack-cocaine or 500 grams of powder cocaine.

Read more
  Subsequently, the law was changed so that a simple possession of 5 grams of crack-cocaine conviction triggered a mandatory 5-year sentence, making it the only Federal, first-time, drug possession charge with a mandatory minimum sentence attached to it.  This difference in penalty cannot be justified based on pharmacological differences between crack cocaine and powder cocaine, because they are quite similar. Further, because 85 percent of Federal crack cocaine defendants are African-American, the mandatory minimum disparity has had a disproportionate racial impact and undermines trust in the criminal justice system. The Administration is actively working with Congress to promote equity in penalties for cocaine-related crimes while retaining the tools needed by law enforcement to protect our communities from the violence associated with drug trafficking.

DOJ ---

4.2.E

Promote Best Practices as Alternatives to Incarceration

Fiscal and public safety concerns have motivated State and local policymakers to consider alternatives to incarceration that protect public safety, provide drug treatment, and avoid the costs and consequences of long-term incarceration.

Read more
  While this Strategy has highlighted a variety of alternatives that have demonstrated some level of effectiveness, much more knowledge is needed about what works and what programs can be taken to scale for the large number of  drug offenders who can be safely supervised in the community.  The use of alternatives to incarceration offers a cost-effective means of alleviating the over-reliance on incarceration for drug-involved offenders.  OJP, in consultation with SAMHSA, will continue to promote innovation and evaluate those new and existing programs that hold the promise of reducing incarceration and maintaining public safety.

DOJ OJP

4.3.A

Support Drug Testing With Certain and Swift Sanctions in Probation and Parole Systems

Offenders whose criminal behavior is driven primarily by substance abuse represent the “low-hanging fruit” among recidivists.

Read more
  Their criminal behavior and drug use, monitored by regular drug tests, can be altered through the consistent application of swift, certain, but modest sanctions, as demonstrated by numerous testing and sanctions programs administered by courts. Research on testing and sanctions sponsored by the OJP has begun to show consistently positive results for such programs in a court setting (e.g., Project HOPE). NIJ recently funded an evaluation of the Delaware Department of Correction’s new “Decide Your Time” program, which is also based on these principles. Potentially, similar results may also be accomplished administratively if probation and parole agencies were given limited authority to impose brief sanctions such as short stints of incarceration. These initiatives have the potential to sharply reduce drug use, crime, and probation revocation, in addition to being able to distinguish those who truly need drug treatment from those who can be induced to stop their drug-taking through other means. The President’s FY 2011 Budget requested $20 million to support “smart probation” programs, building on existing Federal, State, and local efforts. The Administration is committed to evaluating the long-term effects of these types of programs and to funding them, and Federal agencies will continue to look for opportunities to expand them throughout the country in collaboration with State, local, and tribal agencies.

DOJ ---

4.3.B

Consider Mechanisms for Assessing and Intensifying Community Corrections

Community corrections programs can increase public safety, promote public health, and cut costs.

Read more
Community corrections initiatives already play a vital role within our criminal justice system, bearing a tremendous amount of our total national effort to supervise criminal offenders. However, there is significant potential, with sufficient resources and fuller dissemination and implementation of recently identified best practices, for community corrections to have an even greater impact. More information about current efforts, projected workloads, and current staffing and resource challenges are required to better understand community corrections’   potential to promote public safety, foster rehabilitation, and save on incarceration costs. DOJ will assess current funding and staffing for the State and local probation and parole infrastructure and current Federal probation capacity, and will provide recommendations on enhancing outcomes.

DOJ ---

4.3.E

Improve and Advance Substance Abuse Treatment in Prisons

In 2011, BOP will work with BJA and NIC to ensure evidence-based treatment services are provided to Federal prisoners.

Read more
BJA and SAMHSA will also provide training and technical assistance to state RSAT programs with the intent of maximizing the use of evidence-based substance abuse treatment and aftercare for inmates in need of such treatment. New training curricula, incorporating the latest evidence-based practices and aftercare research, will be available through a website. This will advance the field of residential substance abuse treatment for current grantees, as well as for directors, key correctional personnel, and treatment providers implementing or planning to implement residential treatment.

DOJ BOP

4.4.A

Expand Reentry Support and Services Through Second Chance Act and Other Federal Grants

The Second Chance Act authorizes the provision of treatment, employment assistance, housing, family programming, mentoring, victims support, expanded probation and parole supervision, and other services that can help reduce recidivism.

Read more
The Act provides resources to States and local governments to help reduce recidivism by expanding evidence-based prisoner reentry programs. This includes two dedicated programs to provide treatment services for individuals returning to communities from prisons and jails. The number of treatment-focused reentry programs has increased with some measured success (as highlighted in the TASC Update below). The Administration will expand Second Chance-related activities, which include the prosecution-led Drug Treatment Alternatives to Prison program and other efforts.

DOJ ---

4.4.B

Develop Ex-Offender Adult Reentry Programs

Reentry courts are designed to extend the specific, proven practices of drug courts to the management of drug-related offenders being released from incarceration back into the community from a correctional setting.

Read more
It is envisioned that in states where the judiciary has statutory or regulatory authority over offenders upon release (e.g., in states where postincarceration probation or parole are under the authority of the judiciary or where the judiciary can extend supervision beyond prison release, such as split sentencing), reentry courts are attractive, feasible, and ultimately cost effective. Reentry courts should also incorporate the graduated, immediate sanctions and other interventions used by drug courts and related programs with the clinical case management, treatment, housing, and employment services necessary to move these individuals into community recovery. The Administration will continue to fund reentry courts for this population.

DOJ ---

4.4.E

Encourage States Receiving Federal Funds for Corrections Programs To Provide Assistance to BJS in Conducting Annual Recidivism Studies

BJS reports that about 735,000 offenders were released from State and Federal prisons in 2008.

Read more
This tells us there is much work that needs to be done with helping people successfully and productively reenter society from incarceration. However, effective strategies cannot be employed without better data about the size and scope of this problem. BJS is currently funding the Criminal History Record Information Sharing (CHRIS) Project. This project works to create a data-sharing environment that will automate and standardize record retrieval from State criminal history repositories accessed through the FBI’s Interstate Identification Index (or III). The first use of this system will be to study the recidivism patterns of persons released from State prisons in 2005. Almost one-fourth of the prisoners released in 2005 had been incarcerated for drug crimes, so it will be helpful to understand the recidivism of these prisoners and the relation of drug arrests to all released prisoners. BJS and related partners will continue to collect and analyze these data and work with ONDCP to craft appropriate anti-recidivism strategies. BJS and NIJ are working together to examine the feasibility of linking data from the Bureau of Prisons (BOP) about the type of programs in which the inmates participated (such as employment training and education programs) to compare the outcomes from these programs. BJS is also working to link employment and health data to the criminal history records to evaluate the impact of these factors on recidivism.

DOJ BJS

4.5.A

Develop and Disseminate More Effective Models of Addressing Substance Abuse and Mental Health Problems Among Youth in the Juvenile Justice System

Some public and private partnerships are working to better respond to drug and mental health problems among the juvenile justice population.

Read more
These efforts should be expanded to give correctional and health officials a wider array of options. Particular needs include the development of culturally competent screening and treatment interventions for youth housed in juvenile and other correctional facilities as well as the development of evidence-based and promising approaches to diversion and reentry to the community. Another critical need is protocols for conducting screening, brief intervention, and referral to treatment in juvenile justice settings. Because of the multidisciplinary nature of the problems at issue, in addition to nongovernmental partners, the DOJ will work in collaboration with HHS, DOL, ED, and other Federal agencies through its Coordinating Council on Juvenile Justice and Delinquency Prevention to support this initiative.

DOJ OJJDP

5.1.A

Maximize Federal Support for Drug Law Enforcement Task Forces

Federal funding for drug law enforcement task forces enables State and local law enforcement agencies to participate in joint investigations, promotes local and regional coordination, and helps to minimize duplication of effort.

Read more
There are many Federal agencies that support task forces, including DOJ, DHS, Treasury, and ONDCP. DOJ, for example, uses prosecutor-led, multiagency task forces sponsored through its Organized Crime Drug Enforcement Task Force (OCDETF) Program to target drug-trafficking organizations for dismantlement and disruption consistent with the Strategy. These task forces leverage the expertise and resources of the participating Federal, State, and local agencies in a cooperative, coordinated effort against these criminal organizations. DHS leads 17 Border Enforcement Security Task Forces, which leverage Federal, State, local, tribal, and foreign law enforcement resources to identify, disrupt, and dismantle organizations that seek to exploit vulnerabilities in United States borders. Federal agencies are directed to identify ways to enhance State and local participation in Federal drug-enforcement task forces. This can include finding opportunities for efficiencies by reducing duplication of effort within existing fusion centers through co-location or consolidation and better coordination of requests to State, local, and tribal partners to participate in task forces.

DOJ OCDETF

5.1.B

Improve Intelligence Exchange and Information Sharing

Although progress has been made since September 11, 2001, in enhancing information sharing, there is much more to be done. .

Read more
Federal agencies must foster an improved, faster exchange of information with State and local governments; this means a two-way exchange. Local officials need to know what happens to investigative leads they provide to Federal partners and need to see reporting from national authorities that affects the safety and security of their jurisdictions. Federal agencies must work together to ensure that criminal databases include all relevant information, are up to date, and are easily accessible by appropriate local authorities. In recent years, the development of national and State and urban area fusion centers, enhancement of EPIC, and NDIC’s Field Intelligence Officer program, as well as increased dissemination of secure methods for distributing classified information (e.g., via the Secret Internet Protocol Router Network, or SIPRNET) have created new opportunities and new challenges. Fusion Centers must be interconnected and resources leveraged to avoid duplication of effort. For example, the OCDETF Fusion Center has expanded the number of participating Federal agencies to strengthen its fused database and leverage existing systems to further serve the national effort to attack organized crime. As directed in the 2009 Southwest Border Counternarcotics Strategy (Southwest Border Strategy), Federal agencies will commit additional analytical personnel to supplement existing intelligence exchange.

DOJ OCDETF

5.1.C

Ensure State and Local Law Enforcement Access to Federal Information on Mexico-Based Traffickers

Federal agencies, often working in close partnership with Mexico, have produced a large volume of information about Mexico-based drug-trafficking organizations.

Read more
This information must be kept up to date and shared if it is to be used effectively against drug-trafficking organizations. However, this information often resides in different databases. Federal agencies must combine this information and make it available to authorized State, local, and tribal law enforcement so they might benefit from the information gathered. These same local partners should have the ability to add information to this pooled database. Information-sharing architecture is required that will allow State, local, and tribal fusion centers to contribute information on drug-trafficking organizations and drug-related violent crime so that the information can be accessed by all of those with a need to know and be made available rapidly for operational and strategic purposes. DOJ will work with DHS, Treasury, and ONDCP/HIDTA to ensure that information from Federal databases that include relevant data on Mexico-based trafficking organizations is accessible to State and local law enforcement officers who work on these issues.

DOJ DEA

5.1.D

Identify Interior Corridors of Drug Movement and Promote Law Enforcement Collaboration via “Gateway/Destination” Initiatives

Drug traffickers employ our Nation’s roads and highways to move large amounts of drugs, currency, and weapons, both northbound and southbound.

Read more
Although many of these drug-trafficking routes are well known, the volume of traffic makes it difficult to interdict this trade. Further, drug traffickers have shown great resourcefulness in building into all types of vehicles hidden compartments that are often difficult and time-consuming for law enforcement officers to locate. To combat this threat, DEA funds training in contraband detection. The HIDTA program, through its Domestic Highway Enforcement initiative, funds specialized equipment, training, intelligence-sharing activities, and operational travel and overtime expenses to increase manpower focused on highway interdiction. This initiative engages all 48 contiguous states in joint operations planning and intelligence sharing with each other and with Federal agencies, primarily through EPIC. It is vital for Federal agencies to facilitate exchange of information throughout drug-, money-, and weapons-trafficking corridors. Although trafficking patterns do change, drugs that, for example, end up in Atlanta generally enter the United States through the southeastern parts of the Texas border with Mexico. Drug-related violence often follows along such trafficking corridors. Thus, it is extremely productive for law enforcement authorities from trafficking corridors to meet and exchange information on their drug investigations. To broaden knowledge of trafficking organizations and to ensure quick exchange of investigatory leads on targets, Federal agencies will coordinate gateway/destination initiatives with State, local and tribal law enforcement partners throughout the year. Departments and agency task forces will increase collaboration among Federal, State, and local law enforcement working against a common threat in key drug-trafficking corridors.

DOJ DEA

5.1.E

Assist Tribal Authorities To Combat Trafficking on Tribal Lands

There are a host of challenges unique to tribal lands. Many Indian tribes are at high risk from illegal drug trafficking, production, and consumption because these tribes are located in geographically remote areas and suffer from a lack of economic development.

Read more
Illegal prescription drug diversion and abuse has been a particularly worrying problem in recent years. The high poverty and unemployment rates, combined with the challenges of accessing often remote health care, facilities, educational opportunities, and social services, make tribal communities disproportionately vulnerable. In addition, in some tribal lands, there are jurisdictional and investigative challenges for law enforcement, notably, in tribal lands that share international borders with Mexico or Canada. Drug-trafficking organizations exploit these challenges to further their illicit drug trade operations. Federal agencies have sought to provide focused assistance to address these unique challenges. The ICE Shadow Wolves, which continue to play a vital role, were established by Congress in 1974 to address smuggling occurring through the Tohono O’odham Nation. The HIDTA Program has awarded funds in the states of Arizona, New Mexico, Oregon, Texas, Oklahoma, and Washington. In all cases, the HIDTA Task Force Model of multiagency participation was a prerequisite for funding consideration. Other agencies have similarly sought collaborative partnerships with Indian tribes that often lack the resources to effectively combat the illicit drug trade. Due to the threat, particularly on our borders, this challenge will continue to be addressed through additional collaboration by DOJ and HIDTA task forces, in the form of memorandums of understanding (MOUs) among Indian tribes, sheriff’s departments, and HIDTAs; program initiatives; updated intelligence assessments; and cooperative law enforcement efforts from multiagency task forces operating near tribal lands. These efforts will be expanded through additional collaboration with DOJ and HIDTA task forces operating near tribal lands.

DOJ FBI

5.1.F

Ensure Comprehensive Review of Domestic Drug Threat

Drug trends can vary considerably from state to state or city to city. However, a national strategic analysis focusing on the impact of the drug trade can provide a clear and helpful guide in setting the Nation’s agenda among many competing priorities.

Read more
Thus the National Drug Intelligence Center (NDIC) is directed to update the National Drug Threat Assessment, drawing on the expertise, knowledge, and data of both law enforcement and interdiction agencies (e.g., DEA, FBI, ATF, DOD, ICE, USCG, and CPB) and prevention, treatment, and research organizations (e.g., NIDA, SAMHSA, CDC, OJP). This updated assessment will assist ONDCP in reporting on implementation of this Strategy and in developing the 2011 update on the Strategy.

DOJ NDIC

5.3.A

Counter Domestic Methamphetamine Production

Current Federal and most State laws to control pseudoephedrine, the key ingredient needed to make the most powerful form of methamphetamine, are no longer as effective in addressing the serious threat posed by domestic methamphetamine production as they once were.

Read more
Drug traffickers and others are now evading these laws and domestically producing methamphetamine in increasing quantities. Teams of pseudoephedrine purchasers, known as “smurfers,” go from store-to-store throughout California and many other states, some even using global positioning system (GPS) devices to map out every location. This smurfing is feeding not only small neighborhood user labs, but also large-scale “super labs” run by drug-trafficking organizations in California. Although it is important to consider the public health benefits of convenient public access to cold medicines such as pseudoephedrine, domestic meth labs pose serious health and safety risks to the public, law enforcement, and children forced to live in or near such toxic environments. In an effort to address this growing threat, some states are now using comprehensive electronic pseudoephedrine sales monitoring systems. However, those efforts have been unable to prevent a resurgence of small-scale meth production in several states. Facing a similar threat, the State of Oregon, in 2006, returned pseudoephedrine to a prescription drug, as it was prior to 1976. Three years later, the results are very encouraging (see Update below). In early 2010, Mississippi enacted a similar law. In light of recent trends, DOJ will conduct a review of how to best enhance our Nation’s approach to countering domestic meth production, including careful consideration of whether our Federal laws must be updated. In addition, NDIC will continue to monitor and report strategic trends in methamphetamine production and precursor chemical smurfing through production of the annual National Methamphetamine Threat Assessment.

DOJ DEA

5.3.B

Identify Interior Corridors of Drug Movement and Deny Traffickers Use of America's Highways [COMBINED WITH 5.1.D]

Item 5.3.B has been combined with item 5.1.D.

DOJ EPIC

5.3.D

Stop Indoor Marijuana Production

Marijuana trafficking is prevalent across the Nation, with both domestic and foreign sources of supply. California, Hawaii, Kentucky, Oregon, Tennessee, Washington, and West Virginia are considered the top seven (M7) states for marijuana cultivation.

Read more
In 2007 and 2008, cannabis plant eradication increased 34 percent and 14 percent, respectively. Due to this success, many cultivators have been forced to abandon large, outdoor cannabis plots in favor of smaller, better concealed gardens and indoor cultivation. The use of indoor grow operations and other technological advances have enabled traffickers to increase the potency of tetrahydrocannabinol (THC), the psychoactive ingredient in cannabis plants. In 2008, DEA and partner agencies seized in excess of 4,100 indoor grow operations. The leading states for indoor cannabis cultivation in 2008, by number of plants eradicated, were California (182,602 plants), Florida (78,489 plants) and Washington (41,497 plants). DEA, in coordination with State, and local agencies, must aggressively deploy resources as efficiently as possible in close partnership with State agencies to eradicate the marijuana and dismantle organizations that produce it.

DOJ DEA

5.3.E

Partner with Local Law Enforcement Agencies to Combat Street, Prison, and Motorcycle Drug Gangs

Gangs play a major role in distributing drugs and other contraband throughout the country.

Read more
United States law enforcement agencies, in collaboration with State, local, and tribal partners, work to disrupt and dismantle gangs through a variety of initiatives. The National Gang Targeting, Enforcement and Coordination Center (GangTECC) is a national multiagency anti-gang task force that targets the most significant and violent gangs in the United States. GangTECC Federal agents work in close collaboration with Gang Squad prosecutors in the Criminal Division of DOJ and with the analysts at the National Gang Intelligence Center (NGIC) and can offer direct support for those engaged in anti-gang initiatives. The FBI’s Safe Streets Violent Crime Initiative supports 200 task forces to pursue and prosecute violent gangs through sustained, proactive, coordinated investigations. These task forces combine short-term, street-level enforcement activity with financial analysis and Title III wire intercept investigations to prosecute the entire gang, from the street-level thugs and dealers up through the crew leaders and, ultimately, the gang’s command structure. The FBI, in coordination with DEA’s Mobile Enforcement Team and DOJ, will review the effectiveness of these efforts and provide recommendations later this year on how to enhance their impact.

DOJ FBI

5.3.F

Disrupt Illicit Financial Networks by Exploiting Cash Seizures

Bulk seizures of currency, regardless of who makes the seizure or where it is made, should be treated, to the extent allowable by law, as drugs or other contraband are treated.

Read more
The reason to characterize bulk currency as contraband is that it places a stronger focus on investigating and prosecuting those individuals who are transporting the currency. The Texas Department of Public Safety (DPS), for example, partnered with DEA, IRS, ICE, and FBI to put together Financial Investigative Teams that are now deployed to investigate significant currency seizures. Now, 100 percent of individuals caught with illicit proceeds are prosecuted, compared with about 1 percent 5 years ago. In Texas, these initial seizures now lead to controlled deliveries, which enable the identification of coconspirators, detection of currency stash locations, and generation of important leads on major trafficking organizations. Some of these investigations have resulted in the discovery of much more money than what was found at the initial seizure. IRS should facilitate these financial investigations by working directly with and training State and local law enforcement agencies on interviewing suspects and on money-laundering investigative techniques that will increase their financial investigative skills. ICE will continue its focus on bulk cash smuggling through Operation Firewall, and DEA will maintain its Money Trail Initiative coordinated by the Special Operations Division. All Federal agencies listed above will assist State and local partners in conducting currency investigations, provide best practices information, and report back to ONDCP in 2010 on progress in changing the way currency seizures are treated throughout the United States.

DOJ DEA, OCDETF

5.3.H

Establish Interagency Task Force on Drug Endangered Children

The Drug Endangered Children (DEC) national movement emerged as a multidisciplinary response to children exposed to drug use, trafficking, and/or narcotics manufacturing and who are often victims of physical, sexual, and/or emotional abuse; neglect; and drug-related violence.

Read more
Considering the serious risks to the health and safety of drug endangered children, there is a need to support the creation of a DEC infrastructure and increase capacity development at the State, local, and tribal levels. A new Interagency Task Force on Drug Endangered Children will be formed to support the identification of model protocols, programming, and best practices, including the development and implementation of a national multidisciplinary training program to assist States, local, and tribal governments in identifying, responding to, and providing services for drug endangered children. In addition, the new Task Force will identify other tools, protocols, or programs that may assist in protecting children. By establishing these tools and promoting their use under its current authorities, DOJ and all partners will be better able to rescue, protect, and serve the most vulnerable victims of drug-related crimes.

DOJ ---

6.1.A

Conduct Joint Counterdrug Operations With International Partners

The key to countering international drug trafficking is a concerted and synchronized approach to identifying the ever-changing vulnerabilities inherent to drug production and trafficking organizations.

Read more
Once identified, vulnerabilities must be exploited rapidly and intelligently through coordinated action. An example of coordinated strategic counternarcotics action is DEA’s International Drug Flow Attack Strategy (DFAS). The primary objective of DFAS is to cause major disruptions in the flow of drugs, money, and chemicals between the Source Zone and the United States. This effort complements and enhances the overall impact of the interagency Transit Zone operations described below. DOJ/DEA, in coordination with DOD/JIATFS, DHS/USCG, CBP, State Department (including Country Teams led by U.S. Ambassadors), and other Federal departments and agencies, will continue to lead these important operations and work to maximize their impact.

DOJ DEA

6.1.D

Coordinate With Global Partners To Prevent Synthetic Drug Production and Precursor Chemical Diversion

Through partnership with chemical-producing countries such as China and India and through the initiatives of the INCB and the United Nations’ Commission on Narcotic drugs (CND), significant progress has been made in addressing diversion of chemicals used to produce methamphetamine and other drugs.

Read more
It is important to build on this progress and continue to curtail illegal drug production through international investigations such as Operation Ice Block. In January 2008, law enforcement agencies from 54 countries took part in this operation, which sought to gather further intelligence on how methamphetamine precursors are getting into clandestine laboratories and to identify links between involved trafficking organizations. Operation Ice Block focused on licit trade patterns and diversion routes identified by the INCB and was based on the tracking of individual shipments. The operation generated important intelligence on trafficking methods and organizations and identified weaknesses in control mechanisms in a number of countries and regions. These international operations, for which DEA is lead for the United States, should be maintained and expanded to address international precursor chemical diversion.

DOJ DEA

6.3.D

Target Cartel Leadership

Violent, well-funded organizations cannot be eliminated unless their leadership core is identified and brought to justice.

Read more
The “command and control” element of the most significant drug-trafficking organizations affecting the United States drug supply are identified on the Consolidated Priority Organization Target (CPOT) List. The CPOT list represents the “most wanted” of the cartel leadership and ensures that the full capabilities of the United States government are focused, in a coordinated and clear manner, on a group of agreed-upon high-level targets. The Organized Crime and Drug Enforcement Task Force (OCDETF) leads an interagency effort to formulate this list of high-priority international drug trafficker targets. DEA, in close partnership with other agencies and in coordination with international law enforcement organizations, generally leads the multiagency investigations that result in the disruption or dismantlement of CPOT organizations. DEA continues to focus United States capabilities on major drug cartels and should accelerate the rate by which major drug-trafficking organizations, especially those that operate on both sides of the United States-Mexico border, can be put out of business.

DOJ DEA, OCDETF

7.1.E

Strengthen Drug Information Systems Focused on Arrestees and Incarcerated Individuals

Individuals who are arrested and/or convicted of crimes demonstrate substantially higher rates of drug use—especially chronic or hardcore use—than the general population.

Read more
Understanding the interplay between chronic drug use and crime is critical for policymakers, administrators, and communities. To this end, the Arrestee Drug Abuse Monitoring (ADAM) program collects arrestee-reported data on drug use and related behaviors in 10 counties across the country. In addition to self-reported data, ADAM collects a urine sample at the conclusion of the interview. Yet its availability in only 10 counties renders the system of limited value to national decision makers as well as to communities with characteristics different from those of the 10 counties in which data are collected. The Administration will enhance arrestee drug use monitoring to provide better and more timely information about drug use and markets, treatment, and other needs among the arrestee population throughout the country. In addition, ONDCP will coordinate with BJS and NIJ in efforts to survey incarcerated populations about substance use and other issues. BJS conducts periodic surveys of incarcerated populations and currently has a project underway to redesign these surveys to enhance measures of substance use and mental health problems among jail and prison inmates for the next survey iteration.

DOJ NIJ, OJP

7.2.B

Transition Drug Seizure Tracking to the National Seizure System (NSS)

Tabulation of drug seizures is the foundation for reporting statistics on the trends, activities, and patterns related to drug supply reduction policy.

Read more
These statistical data must be archived in a timely, accurate, and complete process to make it an effective and useful source for informing policymakers. For the past 20 years, the gathering of such data has been constrained by the participation of only a few Federal agencies and limited accessibility of the final data. EPIC will therefore implement a National Seizure System that accommodates a broader array of drug seizure information in addition to other related data such as suspect and conveyance details.

DOJ DEA

4.4.D

Provide Work-Related Training and Assistance to Reentering Offenders

DOL’s adult Reintegration of Ex-Offenders (RExO) program assists those leaving prison to reenter society by funding efforts to improve work readiness, education, and self-sustaining employment opportunities.

Read more
Because substance abuse is a widespread problem among the prison population and relapse after release is a frequent contributor to recidivism and a barrier to obtaining stable employment, DOL will continue to work with Federal, and other public/private partners to improve coordination of services to support successful reentry by increasing linkages to available, effective, evidence-based substance abuse treatment services.

DOL ---

1.5.D

Provide Increased Training to Law Enforcement on Identifying Drugged Drivers

As with drunk driving, visible enhanced enforcement has a powerful preventive effect. The Drug Evaluation and Classification Program is a standardized, systematic method

Read more
for law enforcement officers to determine whether observed driver impairment is due to drug use and, if so, to identify the category or categories of drugs involved. More than 6,000 law enforcement officers have received extensive training and have been certified as Drug Recognition Experts (DREs). In the training, participants learn basic drug terminology and pharmacology and how to identify the seven categories of drugs and the indicators of impairment. Training is complete when the participant demonstrates proficiency as a DRE and fully meets the national standards established by the International Association of Chiefs of Police (IACP). Recently, this training program has added more options to enable officers to gain a basic level of training in a short period. Expanding expertise among law enforcement officers in identifying impairment from drug use is a vital public safety priority, and DOT is directed to consult with law enforcement partners on how to supplement current efforts, as well as to seek advice from NIDA on how research findings can be taken into account in the design of the program as they emerge.

DOT ---

1.1.A

Develop Prevention-Prepared Communities

Federal agencies have historically given individual prevention grants focused on single outcomes (e.g., drug use, underage drinking, bullying) to narrow segments of communities (e.g., a parks and recreation department, a school district, a police department) with no coordination among the segments.

Read more
A more effective approach would be for different agencies to work together to target common risk factors that cause a range of problems in youth. In such an approach, building on current programs such as Drug Free Communities, Strategic Prevention Framework-State Incentive Grants, Project LAUNCH, Byrne Criminal Justice Innovation Program Grants (formerly Weed and Seed) and Safe Schools/Healthy Students, the new Prevention-Prepared Communities program (PPC) will focus on youth to conduct epidemiological needs assessments; create a comprehensive strategic plan; implement evidence-based, developmentally appropriate prevention services through multiple venues; and address common risk factors for mental, emotional, and behavioral problems, including substance abuse and mental illness. Agencies would coordinate their grants and technical assistance such that communities and the youth in them are continuously surrounded by protective factors rather than protected only in a single setting or at a single age. An interagency working group, coordinated by the Substance Abuse and Mental Health Services Administration (SAMHSA), will collaborate on the design, implementation, and evaluation of this effort.

HHS SAMHSA

1.1.B

Collaborate with States to Support Communities

A second requirement for reaching our goals is for States to play a more active role in helping communities prepare to implement prevention initiatives.

Read more
State government is the appropriate venue to provide communities the types of prevention-relevant information that will guide those individual communities in the development of their prevention plans (e.g., various school and community surveys, information on drug-related arrests, hospital admissions). SAMHSA will, therefore, in conjunction with the PPC grant program, fund community prevention specialists within States to increase collaboration among State agencies in the development and implementation of community plans. In addition to providing these resources to States, the Federal government will increase efforts to ensure States support community prevention initiatives from the Substance Abuse Prevention and Treatment block grant funds. Twenty percent of these funds are set aside for prevention, but not all States expend the funds in support of community initiatives. SAMHSA will work closely with the States to encourage them to prioritize community prevention initiatives.

HHS SAMHSA

1.1.C

Spread Prevention to the Workplace

Parents are a critical part of prevention efforts. Most parents of young children spend a significant part of their day at work.

Read more
Therefore, the workplace is an excellent site to educate parents about youth substance use and ways to intervene with emerging problems. Furthermore, it is not just parents who can benefit from workplace-centered programs. In the late adolescent years, many young people are employed, and their concentration in particular industries (e.g., food service) creates opportunities for efficient targeting of worksite prevention programs. Federal job-training programs that currently provide substance abuse treatment and referrals will work to ensure continuity of services from training into employment where needed. Relevant Federal agencies will use workforce-focused strategies for delivering prevention messages to employees and their families, including more widespread adoption of effective drug-free workplace programs (which include employee education, supervisor training, testing programs, and treatment referral) by developing and promoting a “best practice” model as a foundation for all employers to implement.

HHS SAMHSA

1.3.B

Expand Research on Understudied Substances

Science is a critical ally in efforts to prevent youth substance use, yet scientific work is not always precisely aligned with the threats communities face.

Read more
One example is the use of inhalants, one of the most common substances of initiation in most communities, but whose impact has not yet been extensively researched. Cognitive (i.e., “study drugs”) and physical performance-enhancing drugs (e.g., steroids), constitute another class of substances abused by youth that requires additional research. Youth abuse of opioid painkillers and other pharmaceuticals should also be more extensively researched. The National Institute on Drug Abuse (NIDA) will actively support research into these youth drug use problems and disseminate the results widely.

HHS NIDA

1.3.C

Prepare a Report on Health Risks of Youth Substance Use

There is a tremendous volume of evidence, from an array of sources, on the negative consequences of substance abuse by young people.

Read more
The Office of the Surgeon General has previously produced useful reports on the health risks of tobacco and alcohol. The Surgeon General is uniquely qualified to provide credible information to parents, teachers, coaches, adolescents, and the general public. The Surgeon General will produce a new report that includes the latest information on the risks of abusing prescription drugs as well as marijuana, other drugs, and alcohol that will be vital to enhancing our efforts to prevent drug use.

HHS OASH

1.5.E

Develop Standard Screening Methodologies for Drug-Testing Labs To Use in Detecting the Presence of Drugs

There are several important scientific issues that must be resolved to establish effective policies and laws on drugged driving.

Read more
Better methods and technology to detect drug use by drivers would have a preventive effect and greatly facilitate the enforcement, prosecution, and adjudication under existing drugged driving laws. First, research must be conducted to develop standards for laboratory screening methodologies for detecting drugged driving. Secondly, research must be conducted to better specify the adverse effects of drug consumption on driving. This information will facilitate the development of model State drug laws to address drugged driving. NIDA will work with its Federal partners to begin this important research.

HHS NIDA

2.1.A

Expand and Evaluate Screening for Substance Use in All Health Care Settings

Screening for substance use should become more broadly implemented in the health care system.

Read more
Even when there is no serious substance use problem present, awareness of the drugs and alcohol a patient is consuming can alert the physician to the risks of adverse medication interactions. It also conveys the important message to all Americans that consideration of substance use should be a standard part of looking after one’s health. SAMHSA will work with accreditation agencies (e.g., The Joint Commission) to increase the number of health care facilities that screen for substance use and support training of health care providers on how to conduct screenings quickly and effectively. Federal agencies that support or operate health care systems (HRSA, IHS, VA, and DOD) will continue to expand screening efforts. NIDA will support these clinical practice improvement efforts by making available its NIDAMED web-based screening instrument, and by funding research on how the use of SBIRT for illicit drug use can be expanded to new health care settings.

HHS HRSA, SAMHSA

2.1.B

Increase Adoption and Reimbursement of SBIRT Codes

In 2007, the Centers for Medicare & Medicaid Services approved reimbursement codes and encouraged state-level funding for physicians and other health care workers to be reimbursed for performing SBIRT.

Read more
However, only 17 states initiated the Medicaid codes to enable billing and even in these states, providers did not perform the expected number of SBIRT interventions. This underutilization is likely due to lack of knowledge about SBIRT and limits on its reimbursement. SAMHSA will collaborate with the National Association of State Medicaid Directors, the National Governors Association, and the National Association of State Alcohol/Drug Abuse Directors to raise awareness of these codes at the state level, and to provide technical assistance to train health care providers on how to bill under these codes.

HHS SAMHSA

2.1.C

Enhance Health Care Providers’ Skills in Screening and Brief Intervention

Unfortunately, a majority of physicians and other health care providers have not been trained and do not feel adequately prepared to provide care for substance use disorders.

Read more
This lack of knowledge reduces providers’ enthusiasm for adopting SBIRT. To address this educational and training deficit, HHS agencies will collaborate to provide training in SBIRT to health care providers throughout the country, particularly in the IHS and in Community Health Centers. SAMHSA will support this effort by developing a Physician Clinical Support System (PCSS) to increase health care providers’ knowledge about addiction and the evidence-based treatments for substance dependence. NIDA will contribute by disseminating curricula on substance use disorders to medical schools around the United States. The goal of these efforts is to equip primary care physicians and other health care providers to screen for, diagnose, and treat a broad range of substance use disorders.

HHS SAMHSA

2.2.A

Educate Physicians About Opiate Painkiller Prescribing

Prescription of opioids is an increasing challenge for clinicians, who have to weigh the substantial pain relief these medications can provide against the potential for dependence, abuse, and diversion.

Read more
Through the PCSS program described above (Section 1, Action C), SAMHSA will train prescribers on how to instruct patients in the use and proper disposal of pain killers, observe signs of dependence, and use prescription monitoring programs to detect doctor shopping. FDA, the agency responsible for reviewing and approving drug applications for prescription pain medications, will play an important role in providing effective information about the proper use and disposal of opioids through approved product labeling and other means to prescribers and patients. Federal agencies that support their own health care systems will increase continuing medical education for their prescribers on proper prescribing and disposal.

HHS SAMHSA

3.1.A

Expand Addiction Specialty Services in Community Health Centers

The Community Health Centers (CHCs) supported by HRSA provide care to more than 16 million low-income Americans at more than 8,000 sites around the country.

Read more
CHC’s have historically not offered extensive specialized services for substance use disorders, which are prevalent in the population they serve. HRSA will increase the ability of CHCs to address substance use disorders and related mental health conditions, both through training of existing staff and through hiring of new staff with specialization in addiction. SAMHSA, which has long partnered with HRSA to improve behavioral health care quality in rural CHCs, will provide technical assistance to this new expansion initiative.

HHS HRSA

3.1.B

Increase Addiction Treatment Services Within the Indian Health Service

Although IHS serves a much smaller population than CHCs, the need for addiction treatment is so great among American Indians and Alaska Natives that it requires an organized, aggressive response.

Read more
Substance use disorders are among the most serious health problems faced by American Indians and Alaska Natives. Moreover, these disorders have destructive effects on a patient’s family, employment, and community life. IHS provides valuable infrastructure in which to embed expanded addiction treatment services. IHS will therefore upgrade its ability to respond to substance abuse by continuing efforts to expand screening and brief intervention. IHS will also add behavioral health counselors and addiction specialists in IHS-funded facilities through a targeted initiative. Coupled with the initiatives to expand screening and brief intervention described in chapter 2, this initiative will greatly enhance the ability of IHS to provide high-quality services for a pressing medical need.

HHS IHS

3.1.D

Enhance Public and Private Insurance Coverage of Addiction Treatment

Federal data show that the majority of uninsured individuals who have substance use disorders have incomes less than 200 percent of the Federal poverty line.

Read more
SAMHSA will educate States on the need to enroll these uninsured Americans in Medicaid, which would expand access to treatment for eligible adolescents and adults. Through its “financing academies” (a technical assistance initiative that builds relationships between State substance abuse agencies, insurance commissioners, and Medicaid directors) and its public statements, SAMHSA will also make State substance abuse treatment providers aware of the opportunities Medicaid presents. To expand resources for treatment in the private sector, the Obama Administration wrote regulations for the parity requirements of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.  These regulations, released on January 29, 2010, make clear that plans offering coverage for substance use disorders cannot impose financial requirements or treatment limitations on substance use disorder benefits that are more restrictive than those imposed for medical/surgical benefits. The Administration will aggressively monitor implementation of parity regulations to ensure group health plans and health insurance issuers are in compliance with the new rules.

HHS SAMHSA

3.2.A

Support the Development of New Medications for Addiction

The effectiveness of addiction treatment has been hampered by the limited range of available FDA-approved medications relative to other chronic medical disorders.

Read more
Fortunately, advances in neuroscience research are identifying promising directions for medication development. New medications include those that help in the acute management of withdrawal symptoms and those that reduce craving for drugs on an ongoing basis. Recent scientific work has also indicated another potential line of productive medication development: vaccines that block the ability of consumed drugs to reach the brain, thereby reducing their reinforcing power. NIDA will continue its funding of medication development research and, in partnership with ONDCP, will identify ways to increase private sector investment in addiction medication development.

HHS NIDA

3.2.B

Develop a Pay-for-Performance Mechanism to Promote the Quality of Publically Funded Substance Abuse Treatment

Some States and Federal systems (e.g., VA) have had significant success in building financial incentives into public health care systems.

Read more
In these Pay for Performance (P4P) contracting arrangements, treatment programs that do a better job of serving addicted patients promptly and effectively are rewarded. Federal funding for substance abuse treatment, which is provided to States by SAMHSA, has not historically been contingent on the quality of the services received. A trial of P4P contracting in a limited number of States may help improve treatment quality and lay the groundwork for a national effort in this area. The Obama Administration will create a mechanism at SAMHSA to incentivize a subset of States to reward those treatment programs that implement evidence-based clinical practices and are more successful at promoting and sustaining recovery.

HHS SAMHSA

3.2.D

Equip Health Care Providers and First Responders To Recognize and Manage Overdoses

Overdoses, particularly from opiates, are a growing national crisis, and health care providers need to be able to recognize and intervene in overdose emergencies.

Read more
The goal of such interventions must be not only to avert the immediate crisis, but also to link the patient to addiction treatment. The Administration will seek to expand the number of physicians, nurses, emergency medical technicians, law enforcement professionals, and firefighters who are trained in how to recognize an overdose and who further know how to administer life-saving techniques and overdose reversal medications such as naloxone. This initiative will be pursued through continuing education programs and through work with State licensing and accreditation bodies.

HHS CDC

3.2.E

Seek, Test, and Treat HIV in the Criminal Justice System

Providing highly active anti-retroviral therapy (HAART) and addiction treatment concurrently could make a huge public health impact, particularly with HIV-positive, drug-using populations who have poor access to health services.

Read more
Incarcerated criminal offenders are one such high-risk group: Half of State and Federal prisoners meet criteria for alcohol or drug addiction, and approximately 14 percent of all HIV-infected people pass annually through the criminal justice system. Building on CDC’s expanding HIV testing initiative, NIDA will support work to develop and test strategies for identifying individuals who have not recently been tested (seek), provide HIV testing to them (test), and initiate, monitor, and maintain HAART therapy for those who test positive (treat), along with providing evidence-based treatment for addiction. Parallel treatment of HIV and addiction will follow a chronic care model of disease treatment and follow CDC recommendations for the initiation of HAART. HHS intends that this initiative will not only expand access to HIV testing for those in the criminal justice system, but will improve the provision and maintenance of HAART after community reentry.

HHS NIDA

3.3.A

Expand the Access to Recovery Program

Access to Recovery (ATR) is an innovative program that provides drug-addicted individuals vouchers with which they can purchase clinical treatment and recovery support services, including transitional housing, child care, transportation to work or to recovery mutual help group meetings, peer counseling, and aids to employment restoration (e.g., the purchase of a pair of work boots).

Read more
Many of the services provided under this program are offered by associations of recovering people or by faith-based organizations. Receipt of ATR services has been shown by research to increase the likelihood of recovery. As a voucher program, ATR has a further potential benefit, in that giving the consumer a choice of services can drive quality of care, because it forces providers to compete for business. The Administration is therefore expanding the ATR program, allowing more individuals to access the package of services that supports their recovery and to improve the quality of care systemwide.

HHS SAMHSA

3.3.C

Foster the Expansion of Community-Based Recovery Support Programs, Including Recovery Schools, Peer-Led Programs, Mutual Help Groups, and Recovery Support Centers

Recovery support programs provide less formal, more enduring support than the professional treatment system, which makes them highly appealing to people in recovery.

Read more
A key example is recovery schools, which educate high school and college students in an atmosphere that supports students’  recovery. The Department of Education will make itself available for consultation to agencies and school districts that support recovery schools. SAMHSA will fund recovery support efforts through Access to Recovery (see section A, above) and through grants to develop local recovery-oriented systems of care. In addition, government funded clearinghouses, websites and help-lines will be encouraged to maintain updated lists of mutual help groups (e.g., Narcotics Anonymous, SMART Recovery, Women for Sobriety) and to provide them as a potential resource to individuals seeking help for substance use disorders.

HHS SAMHSA

4.3.C

Align the Criminal Justice and Public Health Systems To Intervene With Heavy Users

Years of research have demonstrated that heavy users, a minority of the drug using population, consume a disproportionately large share of illegal drugs.

Read more
Yet research has also shown that in the general population, fewer than 10 percent of all diagnosed cases of addiction receive treatment. This treatment gap is of even greater concern with regard to heavy users, as they are often the most difficult population to bring into contact with treatment and recovery services. Traditional services often are ineffective or less effective with this population, considering the extent of their addiction problems. Nonetheless, the benefits of helping these individuals are significant. Beyond the obvious public health concern, these heavy users represent the economic underpinning of the illegal drug industry, supporting retailers, wholesalers, and suppliers who profit from daily purchases. Intervening with these heavy users would not only help bring treatment to those who need it most, but it would also serve to significantly undermine the illegal drug economy. Neither the criminal justice system nor the public health sector can address the challenges and special needs of heavy users by operating in isolation. DOJ and HHS will convene a study group with interagency partners to examine ways the Federal government can partner with State and local authorities to identify and assist heavy users in local markets through comprehensive, tailored interventions, including such measures as drug courts, in- and outpatient treatment, detoxification, rehabilitation, and enhanced probation and reentry services.

HHS SAMHSA

4.3.D

Tackle Co-Occurring Disorders Using a Community-Based Response

An increase in the assessment of substance abuse disorders in the criminal justice system setting has alerted experts to the reality of other co-occurring disorders (e.g., psychiatric disorders, infectious diseases, chronic pain) that can accompany and are often exacerbated by substance abuse.

Read more
Behavioral health scientists and criminal justice system stakeholders can make an enormous impact on these populations by expanding services at all points in the system, especially in the context of postbooking and post-arraignment jail diversion programs. These programs focus on providing services including integrated dual diagnosis treatment, cognitive behavioral therapy, medication management, psychiatric rehabilitation, supported housing, supported employment, and illness-specific mutual help groups. The Administration will continue to support these initiatives that recognize the co-occurring disorders of mental illness and substance abuse.

HHS SAMHSA

7.1.A

Enhance the Drug Abuse Warning Network Emergency Department Data System

DAWN provides national and local-area estimates of drug-related emergency department visits, and drug-related mortality.

Read more
This system is central for assessing the impact of drug use on the health care system and on the health of the population. The FDA, for example, uses DAWN as an indicator of potential side effects of previously approved prescription drugs. The system is not fully capable of meeting national and local needs and suffers from antiquated data collection procedures that do not provide timely results. SAMHSA will work with ONDCP and FDA to develop options to improve DAWN’s timeliness and its accuracy, including identifying agencies that rely on the data and could collaborate with SAMHSA to maintain DAWN’s viability.

HHS SAMHSA

7.1.B

Improve the National Survey on Drug Use and Health

SAMHSA’s NSDUH is the Federal government’s primary survey on substance use (including illicit drugs, alcohol, and tobacco) and related health conditions among the United States population.

Read more
Data from NSDUH have been used to examine a wide array of issues, including trends in youth drug use, co-occurring illness, the prevalence of substance abuse and dependence, risk and protective factors, and marijuana market characteristics. Important steps to preserve sample size and flexibility (i.e., the ability to generate State-level estimates) have already been taken, but further opportunities to strengthen NSDUH remain. Through its interagency workgroup process, ONDCP will work with SAMHSA to make design improvements to NSDUH, including considering whether it would be feasible and valuable over the long term to transition to conducting its general population survey only every other year, and conducting surveys of other important populations (e.g., people in recovery; residents of rural areas; the lesbian, gay, bisexual, and transgender population; drug-using individuals who are incarcerated; homeless individuals who are not in shelters) in the intervening years.

HHS SAMHSA

7.1.C

Sustain Support for the Drug and Alcohol Services Information System

DASIS consists of two data sets: the Treatment Episode Data Set (TEDS) and the National Survey on Substance Abuse Treatment Services (N-SSATS).

Read more
TEDS provides State-compiled data recorded at admission to specialty treatment programs. N-SSATS is also reported directly by treatment programs and provides data on the location, characteristics, services offered, and utilization of substance abuse treatment providers. Data from the latter are used to populate SAMHSA’s web-based Substance Abuse Treatment Locator, which helps Americans locate the services they need. TEDS provides useful data on the population of annual treatment admissions for substance abuse. This information has been useful for planning state-level treatment responses to changes in the demand for treatment such as the recent rise in admissions for treatment for marijuana and for opiate prescription pain relievers. SAMHSA will work with ONDCP to sustain DASIS and increase the speed with which makes its data available.

HHS SAMHSA

7.1.D

Improve the National Survey on Drug Use and Health

SAMHSA’s NSDUH is the Federal government’s primary survey on substance use (including illicit drugs, alcohol, and tobacco) and related health conditions among the United States population.

Read more
Data from NSDUH have been used to examine a wide array of issues, including trends in youth drug use, co-occurring illness, the prevalence of substance abuse and dependence, risk and protective factors, and marijuana market characteristics. Important steps to preserve sample size and flexibility (i.e., the ability to generate State-level estimates) have already been taken, but further opportunities to strengthen NSDUH remain. Through its interagency workgroup process, ONDCP will work with SAMHSA to make design improvements to NSDUH, including considering whether it would be feasible and valuable over the long term to transition to conducting its general population survey only every other year, and conducting surveys of other important populations (e.g., people in recovery; residents of rural areas; the lesbian, gay, bisexual, and transgender population; drug-using individuals who are incarcerated; homeless individuals who are not in shelters) in the intervening years.

HHS SAMHSA

7.3.A

Develop a Community Early Warning and Monitoring System That Tracks Substance Use and Problem Indicators at the Local Level

National indicators may bear little resemblance to what is happening in any individual community.

Read more
Meanwhile, many measures available at the local level (e.g., drug-related arrests and incarcerations; drug-related hospital admissions and emergency department visits; drug-related school accidents or punishments) are not fully captured in national data sets, impairing ability to detect emerging problems in particular states or regions. Led by SAMHSA, and with extensive input from NIDA and the many other Federal agencies that participate in ONDCP’s Interagency Working Group Data Committee, the Administration will develop a new Community Early Warning and Monitoring System. This system will develop a national model for capturing community-level data that not only fill in the gaps in national policy-level information but also serve to identify regional and local drug problems. This system will be designed to serve as a near real-time drug information network that warns of emerging drug threats and provides ongoing information on the effectiveness of drug control policies and programs.

HHS SAMHSA

4.4.C

Facilitate Access to Housing for Reentering Offenders

Stable and affordable housing is often identified as the most difficult barrier for individuals to overcome when they are released from prison or jail.

Read more
Mapping work by the Council of State Governments Justice Center confirms that in many states, there are specific neighborhoods containing large numbers of people under criminal justice supervision. Federal investments in reentry should focus on these neighborhoods and communities and encourage services for the criminal justice population that would not only reduce recidivism and increase public safety, but also support the long-term goals of recovery from alcohol and drug addiction. Supportive living environments and a drug-free home are a key part of recovery. They represent a remarkably effective and low-cost method of preventing relapse. It is important to identify the types of settings or interventions that might promote health service utilization and more positive health outcomes following release from jail for those with substance abuse issues and co-occurring disorders. Structured and supportive recovery homes are keys to promoting healthy outcomes and increasing positive health behaviors through social support. Many of these housing programs are primarily self-financed through rent paid by residents. HUD and DOJ will support sober recovery and reentry housing.

HUD ---

6.3.A

Improve Our Knowledge of the Vulnerabilities of Drug-Trafficking Organizations

ODNI, DOJ, and DHS will convene all interagency intelligence organizations to marshal their expertise on drug-trafficking organizations, their vulnerabilities, and mechanisms to attack these vulnerabilities.

Read more
In order to ensure United States law enforcement agencies are maximizing the impact of their operations on trafficker capabilities, DOJ and DHS will assess current efforts and make recommendations on additional actions to departmental secretaries.

ODNI ---

4.1.B

Engage Faith-Based and Neighborhood Community Organizations To Prevent Drug-Related Crime

The faith-based community and other neighborhood partnerships are traditional pillars of support for drug prevention and treatment efforts.

Read more
  They are a powerful force of change for millions of Americans, yet they also remain an untapped resource in many communities to prevent and reduce drug-related crime. The Office of Faith-Based and Neighborhood Partnerships (OFBNP), in coordination with ONDCP, will work with community-based nonprofit organizations to identify funding streams and areas of possible collaboration.  For example, one way we can engage in reducing drug-related crime is for organizations to act as catalysts for positive opportunities in a community. OFBNP and the Administration of Children and Families offered $50 million in Recovery Act funding for a Strengthening Communities Fund to build the capacity of nonprofit organizations, whether secular or faith-based, to address the broad economic recovery issues present in their communities, including helping low-income individuals secure and retain employment, earn higher wages, obtain better-quality jobs, and gain greater access to Federal and State benefits and tax credits. This is just one novel mechanism for strengthening communities, as faith-based and other neighborhood partnerships have multiple roles to play in the community.  In addition, faith-based organizations have played major roles in Drug Market Interventions (see section 1A), as faith and community leaders remain powerful influences for positive change. Similarly, fraternities and sororities on college campuses remain potential partners for community change.

OFBNP ---

1.2.A

Strengthen the Drug Free Communities Program

The Drug Free Communities Support program is a signature effort to bring a broad range of community stakeholders together to prevent youth drug, alcohol, and tobacco use.

Read more
In partnership with SAMHSA, ONDCP has administered the Drug Free Communities (DFC) program since 1997. The DFC program is a matching grant effort designed to help community coalitions identify and respond to local youth substance use problems. With 746 grants in 726 communities, the DFC program has been implemented in all 50 States, the District of Columbia, Puerto Rico, Palau, American Samoa, the U.S. Virgin Islands, and in tribal communities. Community-based coalitions bring together more than a dozen sectors (e.g., law enforcement, schools, faith leaders) to change local environmental risk factors. Communities are best equipped to identify local drug problems, mobilize local resources, and implement community-based action plans. The Administration will work to provide best practices information to community coalitions and to integrate their work into new Federal prevention efforts. Additionally, the Administration will encourage further outreach of DFCs into special populations, including tribal communities.

ONDCP ---

1.2.B

Revamp and Reenergize the National Youth Anti-Drug Media Campaign

Influencing youth attitudes toward drugs is an important part of preventing drug use. Because the current media environment of youth includes pro-drug content that normalizes drug use,

Read more
it is critical that anti-drug messages be delivered in the media to neutralize these influences. Any effort to achieve this goal must recognize that youth now engage with media in radically different ways than before. In consultation with national experts in media, marketing, and technology, the Obama Administration is dramatically changing the ONDCP National Youth Anti-Drug Campaign to respond to changes in the media. This effort builds on the strength of the Campaign’s  “Above the Influence” brand, which encourages teens to reject drugs and other negative influences in their lives and has successfully achieved more than 80-percent awareness among youth, on par with mega-brands such as Burger King®, Coca-Cola®, and Nike. On average, the “Above the Influence” website receives 800,000 visits a month. The revamped Campaign will increase its emphasis on teen-centric television, print, and digital media and place more relevant content on teen destination websites. It will also be tailored to high-risk youth populations who suffer disproportionally from drug problems.

ONDCP ---

1.2.C

Support Mentoring Initiatives, Especially Among At-Risk Youth

Mentoring can play a critical role in a child’s development. Data indicate that mentoring programs can help young people, including those with incarcerated parents or

Read more
those who are children of alcoholics and/or drug users, by reducing their drug and alcohol use, improving their relationships and academic performance, and reducing the likelihood they will initiate violence. Multiple grant programs administered by the Departments of Health and Human Services and Justice provide services (both directly and in collaboration with local agencies) to strengthen and support children, especially those at higher risk of initiating substance abuse. For example, the Faith-Based and Neighborhood Partnerships Initiative provides more than $45 million in funding to support the children of incarcerated parents through mentoring recruitment and support services. Additionally, DOJ’s Office of Juvenile Justice and Delinquency Prevention, which administers juvenile mentoring grants, will conduct a new mentoring training initiative in the current year.

ONDCP ---

1.2.D

Mobilize Parents To Educate Youth to Reject Drug Use

Parents can play a key role in preventing drug and alcohol use and abuse because they are the first and most important continuing influence on the intentions and behaviors of children and adolescents.

Read more
Initiation of substance use increases during the adolescent years but is often preceded by biological, psychological, social, and environmental precursors that begin earlier in life. Communities must harness their power and equip parents with information to help keep their families safe and healthy. To support this effort, the White House Office of Faith-Based and Neighborhood Partnerships is fostering greater engagement of fathers in the lives of their children. It has launched a national fatherhood tour to hear directly from local communities about how we can come together to encourage personal responsibility and strengthen our Nation’s families. This program works synergistically with initiatives to help fathers and mothers protect their children from drugs. The National Youth Anti-Drug Media Campaign continues to provide information and resources to parents, and SAMHSA continues to provide support for parents using evidence-based interventions.

ONDCP ---

1.4.A

Provide Information on Effective Prevention Strategies to Law Enforcement

During the Strategy consultation process, many law enforcement professionals indicated that information on the effectiveness of various prevention strategies and programs is not easily available.

Read more
Many police agencies with substantial experience in implementing problem-oriented policing strategies are well prepared to promote and participate in effective prevention programs if both the right initiative and sufficient funding can be identified. The Administration will respond by creating documents for criminal justice and other agencies highlighting which prevention strategies can be effectively implemented and how to acquire additional information to launch such strategies.

ONDCP ---

1.4.C

Strengthen Prevention Efforts Along Southwest Border

Just as increased national and bi-national collaboration can improve interdiction, intelligence, and enforcement efforts along the United States-Mexico border, an increased and more coordinated emphasis on substance abuse prevention will benefit both countries in border regions.

Read more
Despite many excellent alliances and programs, prevention efforts along the border region remain fragmented. Therefore, ONDCP will establish and lead a Federal working group to promote communication and collaboration with State, local and tribal agencies, bi-national organizations and agencies, and Mexican counterparts to maximize available resources in addressing the common factors that influence the region’s violence and substance abuse. Prevention is essential for long-term solutions to the region’s substance abuse and related problems, including the recruitment of youth into gangs. Many conditions and issues that impact broken communities – sometimes affecting the ability and even the will of communities to mobilize to address them – exist on both sides of the border. The ONDCP-led workgroup will identify, recruit, and engage key stakeholders on both sides of the border to work together to address the problems. This effort will build on annual United States-Mexico Bi-national Demand Reduction Policy meetings, bringing together high-level officials committed to improving demand reduction efforts and establishing teams from both countries to work together on building capacity to address specific issues, such as strengthening communities, coalition building, conducting clinical research trials in prevention and treatment to reach vulnerable populations, gang prevention and intervention approaches, criminal justice innovations, and recovery support efforts.

ONDCP ---

1.5.A

Encourage States To Adopt Per Se Drug Impairment Laws

State laws regarding impaired driving are varied, but most State codes do not contain a separate offense for driving under the influence of drugs (DUID).

Read more
Therefore, few drivers are identified, prosecuted, or convicted for DUID. Law enforcement personnel usually cite individuals with the easier to prove driving while intoxicated (DWI) alcohol charges. Unclear laws provide vague signals both to drivers and to law enforcement, thereby minimizing the possible preventive benefit of DUID statutes. Fifteen states have passed laws clarifying that the presence of any illegal drug in a driver’s body is per se evidence of impaired driving. ONDCP will work to expand the use of this standard to other states and explore other ways to increase the enforcement of existing DUID laws.

ONDCP ---

1.5.B

Collect Further Data on Drugged Driving

Much greater efforts are required by Federal and local agencies to focus on the serious drugged driving threat, but these efforts must be built on a strong foundation of accurate data.

Read more
Data sources to track drugged driving among the overall population include SAMHSA’s National Survey on Drug Use and Health and NHTSA’s National Roadside Survey of Alcohol and Drug Use by Drivers. In addition, NHTSA’s Drug Evaluation and Classification program captures information on drug evaluations conducted on drivers arrested on suspicion of impaired driving. Further, the Fatality Analysis Reporting System, known as FARS, provides testing results for drivers in fatal car crashes. FARS data on drug use for 80 percent or more of all fatally injured drivers is available for 15 states. The National Roadside Survey of Alcohol and Drug Use by Drivers is the only survey of non-crash-involved drivers using a specific biomarker (generally a blood or saliva test) that confirms the presence of drugs in those who volunteer to participate in the survey. NHTSA has conducted the National Roadside Survey on a 10-year cycle, most recently in 2007. The Survey estimates the use of alcohol and other potentially impairing drugs by drivers. Federal drug control agencies will reduce the length of time between National Roadside Surveys as one measure of progress on drugged driving.

ONDCP ---

1.5.C

Enhance Prevention of Drugged Driving by Educating Communities and Professionals

There has been insufficient effort to educate all relevant stakeholders, including government agencies, parents, schools, faith communities, community coalitions, and medical professionals, about the serious threat posed by drugged driving.

Read more
ONDCP will provide educational materials on drugged driving in as many venues as possible, as this information can be of value to a broad range of individuals. Doctors can help by learning to recognize patients with substance use problems. Parents can help by talking to their children about alcohol and drugs and the dangers of driving after drinking alcohol or using drugs. Communities can reinforce the message that there are serious consequences associated with abusing alcohol or drugs. Individuals who use drugs can seek help and make the choice to live a drug-free life. ONDCP will work with stakeholders to launch a national initiative to greatly expand our efforts to reduce drugged driving.

ONDCP ---

3.1.E

Inform Public Health Systems on Implementation of Needle Exchange Programs

On December 16, 2009, President Obama signed into law an end to the longstanding ban on most Federal funding for needle exchange programs.

Read more
In partnership with the White House Office of National AIDS Policy, ONDCP will issue policy guidance to States, tribes, and communities on how to implement needle exchange programs in the context of comprehensive, recovery-oriented public health systems that also offer intravenous drug users treatment for addiction, other medical care, and testing for HIV and hepatitis B and C. HHS will coordinate efforts related to needle exchange programs among those HHS agencies affected by the lifting of the ban. CDC also will provide programmatic guidance, technical assistance, and training to its funded grantees.

ONDCP ---

3.2.C

Promulgate the National Quality Forum Standards for Addiction Treatment

The National Quality Forum (NQF) is a voluntary public-private partnership that brings together diverse health care stakeholders in an effort to develop a common vision for health care quality improvement.

Read more
Because of its broad stakeholder representation and formal consensus development process, NQF-endorsed policies are referenced in many States’   laws as “voluntary consensus standards.” In 2007, NQF issued a set of National Voluntary Consensus Standards for the Treatment of Substance Use Conditions. These comprise 11 evidence-based practices organized into 4 major domains: (1) identification of substance use conditions, (2) initiation and engagement in treatment, (3) therapeutic interventions to treat substance use illness, and (4) continuing care management of substance use illness. Efforts are now underway to disseminate and adopt these standards nationwide to improve the effectiveness, efficiency, and cost-effectiveness of substance use disorder treatment by assuring consistent implementation of proven clinical, administrative, and organizational practices. ONDCP, through its Health Care Delivery Workgroup, will collaborate with the leadership of key agencies to promote: (1) adoption of the full set of practices in the public and private sectors; (2) policy development, including alignment of payment/reimbursement and coverage and legal and regulatory policies; (3) development and implementation of measures based on each of the standards, their specifications, and target outcomes; and (4) continuing research to improve standards so they do not become static.

ONDCP ---

3.3.B

Review Laws and Regulations That Impede Recovery from Addiction

Many laws and regulations that were established for the purpose of punishing or deterring drug use make no distinction between the person who continues to use drugs and the person who is on the pathway to recovery and needs housing, employment, a driver’s license, or a student loan to fully rejoin society.

Read more
If such laws are either repealed or modified in a fashion that allows exemption of recovering people from their effects, a greater number of addicted individuals in early recovery will succeed in the long-term goals of becoming healthy and productive members of society, and recidivism will be reduced. ONDCP will work with the Congress and Executive Branch agencies to identify opportunities to eliminate legislative and regulatory barriers to recovery.

ONDCP ---

3.3.D

Deliver Quality Recovery Support Services to Veterans and Military Families

Consistent with the Presidential Study Directive – Strengthening Our Military Families, ONDCP will lead an interagency effort to identify recovery support services

Read more
for alcohol and drug addiction that are appropriate for active duty military, Veterans, and their families and to ensure that those services are made available to our military families to the greatest extent possible.

ONDCP ---

4.2.F

Improve Intervention and Treatment Services for Female Offenders in the Juvenile and Criminal Justice Systems

ONDCP will work with the Women and Trauma Federal Partners’ Committee to support interventions

Read more
(including sentencing alternatives to incarceration, expansion of family-based treatment, improved conditions of maternal incarceration, and increased support for programming focused on parent-child relationships during a mother’s sentence) and work to incorporate these issues into Federal programs and funding requests.

ONDCP ---

4.2.G

Examine Interventions and Treatment Services for Veterans within the Criminal Justice System

ONDCP, in partnership with DOD, VA, HHS/SAMHSA, DOJ, and other stakeholders, is taking steps to address Veterans within the criminal justice system.

Read more
The role of traumatic brain injury and post traumatic stress disorder (PTSD) in substance abuse and mental health will be more fully examined in the Veterans treatment court initiative. This is just one of many initiatives designed to reduce the burdens that multiple deployments, combat injuries and trauma, the challenges of reintegration, and substance abuse can have on military families.

ONDCP ---

4.2.I

Address the Issue of Drug Use and Drug-Related Crime for American Indian/Alaska Natives

The significant problems of drug use and drug-related crime in tribal regions throughout the Nation pose a critical challenge for Federal, state, local, and tribal leadership.

Read more
In 2011, ONDCP and OJP will consult with tribal leaders, including the National Congress of American Indians and United South and Eastern Tribes (USET), to develop a plan to tackle some key issues regarding drug use and crime and to discuss their role in the involvement of Native American and Alaskan Natives in the criminal and juvenile justice systems.

ONDCP ---

5.2.A

Implement the Southwest Border Counternarcotics Strategy

On June 5, 2009, Attorney General Holder, DHS Secretary Napolitano, and ONDCP Director Kerlikowske released the Southwest Border Strategy, which aims to stem the flow of illegal drugs and their illicit proceeds across the southwest border and reduce associated crime and violence in the region.

Read more
It directs Federal agencies to increase coordination and information sharing with State and local law enforcement agencies, intensifies national efforts to interdict the south-bound flow of weapons and bulk currency, and calls for continued close collaboration with the Government of Mexico in their efforts against the drug cartels. The Southwest Border Strategy is an important component of the Administration’s national drug control policy and complements comprehensive efforts to respond to threats along the border. This Southwest Border Strategy, the product of a collaborative interagency effort led by the DHS Office of Counternarcotics Enforcement (CNE) and DOJ’s Office of the Deputy Attorney General at the direction of ONDCP, shall be fully implemented.

ONDCP ---

5.3.C

Eradicate Marijuana Cultivation on Public Lands

Drug-trafficking organizations (DTOs), generally those with links to Mexican cartels, are exploiting United States territory, especially public lands, for the cultivation of marijuana.

Read more
Moreover, marijuana is being cultivated by traffickers from Mexican DTOs at remote outdoor grow sites on a number of Indian reservations, particularly those in the Pacific Northwest. Often, these marijuana fields are guarded 24 hours a day by armed criminals and sometimes protected by booby traps, thereby posing a significant threat to public safety. In addition, significant environmental damage results from marijuana cultivators camping for extensive periods in pristine public lands and using fertilizers and other chemicals. Federal agencies have worked with their State, local, and tribal government counterparts to respond to marijuana cultivation. By coordinating their efforts and pooling their resources, they have eradicated record numbers of marijuana plants each year for the past 5 years. Support from Federal agencies and information on the precise location of clandestine marijuana fields from State, local, and tribal agencies is crucial to those responsible for managing public lands, especially as trafficking organizations expand to additional states. The DEA, National Guard, and HIDTA Task Forces, as well as State and local agencies, have provided critical support in funding, helicopter support, and intelligence analysis. ONDCP, through the HIDTA program, provides funding for investigation and eradication of marijuana plantations through the Domestic Marijuana Eradication and Investigation Project (DMEIP). ONDCP will collaborate with DEA and the Departments of the Interior, Agriculture, and other agencies to review the current threat as assessed by NDIC and work to increase the effectiveness of marijuana eradication.

ONDCP HIDTA

6.1.G

Enhance the Relationship Developed with Russia Under the U.S.—Russia Bilateral Presidential Commission to Encourage Counternarcotics Cooperation

This Administration established a Counternarcotics Working Group under the Bilateral Presidential Commission co-chaired by ONDCP Director Gil Kerlikowske and Russian Federal Drug Control Service (FSKN) Director Viktor Ivanov.

Read more
The Working Group addresses a range of drug control issues between the United States and the Russian Federation, including reducing narcotics originating in Afghanistan; disrupting financial operations of major drug trafficking organizations (DTOs) in Central Asia; and exchanging information and best practices on demand reduction programs.

ONDCP ---

6.2.G

Leverage Capacities of Partner Nations and International Organizations To Help Coordinate Programs in the Western Hemisphere

Drug-trafficking organizations have broadened their operational activities to a wide array of Western Hemisphere countries.

Read more
Traffickers now move drugs, money, weapons, chemicals, and personnel by various routes and through numerous nations. It is time for the United States, in close collaboration with partner nations, to develop, fund, and implement a comprehensive hemispheric counterdrug strategy encompassing both demand reduction and supply reduction efforts. ONDCP will form a working group to draft the strategy with full involvement from all of the relevant interagency partners.

ONDCP ---

7.2.A

Develop and Implement Measures of Drug Consumption

Economic analyses of drug use and drug markets are essential to assessing the effectiveness and cost-effectiveness of drug control policies and programs.

Read more
Yet the two most critical variables needed to assess the impact of drug policy are lacking: (1) how much of the commodity of interest (drugs) is consumed and (2) its price (for a discussion of drug prices, see item 1D above). Consumption refers to the amount of the substance consumed over a given period of time. Prevalence—the measure of drug use currently available—is the proportion of the population who use drugs in a given period (e.g., the past week, month, or year). None of the existing government surveys provides a reliable and direct estimate of the total amount of drugs consumed by Americans; such surveys may not be the most appropriate method for obtaining consumption estimates due to the difficulty of reliable respondent recall. Finally, even if these two essential data elements were available nationally, they need to be available at the community level if they are to be useful in local policy development and assessment. ONDCP, SAMHSA, NIDA, NIJ, and BJS will work together to identify approaches to estimating drug consumption nationally and at the community level, determine whether any of the identified approaches are feasible, and, if so, work to implement a sound approach.

ONDCP ---

7.2.C

Enhance the Various Data That Inform Our Common Understanding of Global Illicit Drug Markets

The Interagency Assessment of Cocaine Movement (IACM), an annual report designed to estimate cocaine flow, is informed by data from a wide array of State, local, and Federal agencies as well as our international partners.

Read more
It uses as a primary source of information the Consolidated Counterdrug Database (CCDB), which has been enhanced in recent years by participation from the United Kingdom’s Serious Organized Crime Agency (SOCA). United States agencies will continue to improve CCDB by pursuing and implementing measures to increase efficiency and thoroughness. Federal agencies will also continue to improve the IACM by considering the inclusion of new data sources and new analytic methodologies.

ONDCP ---

7.2.D

In Coordination With Our International Partners, Improve Capacity for More Accurately, Rapidly, and Transparently Estimating the Cultivation and Yield of Marijuana, Opium, and Coca in the World

The United States Government produces annual estimates of illicit crop cultivation and illicit drug production in key source countries around the world in an effort to frame the threat of illicit drugs to the United States and its allies.

Read more
The myriad variables involved in production estimates and rapidly changing tactics by illicit drug producers make it imperative that the information used to calculate those estimates be refined. The State Department and other agencies will continue to work with our international partners and UNODC to improve our understanding of the cultivation and production process and to refine the United States methodology for producing these estimates.

ONDCP ---

6.1.F

Expand Internationally a Comprehensive Package of Health Interventions for Injection Drug Users

The President’s Emergency Plan for AIDS Relief (PEPFAR) is the largest effort by any nation in history to prevent and treat a single disease.

Read more
Injection drug users (IDUs) not only suffer high risk of addiction and overdose, but they are also at high risk for infection with HIV and other blood-borne and sexually transmitted infections. Comprehensive prevention and treatment services for IDUs reduce immediate risks of HIV transmission as well as promote recovery from addiction. In multilateral forums, the Obama Administration has supported a package of health interventions for IDUs that mirrors those recommended by the World Health Organization, UNODC, and the United Nations Office on AIDS (UNAIDS). The UNAIDS Technical Guide recommends that programs directed toward IDUs include a comprehensive package of nine activities, including addiction treatment. PEPFAR will work with agencies across the Federal government to determine the best way forward in supporting this comprehensive package.

PEPFAR ---

6.1.B

Work With Partner Nations and OAS/CICAD To Strengthen Counterdrug Institutions in the Western Hemisphere

The United States will actively cooperate with those partner nations that are most directly victimized by drug production that flows toward the United States, that are most at risk from international drug-trafficking organizations, and that are committed to counterdrug efforts and the rule of law.

Read more
United States outreach will also occur through regional organizations such as OAS/CICAD, where the United States has been elected to a 1-year term as chair for the first time in the OAS’s history. There are several unique regional challenges that can be addressed effectively through a regional response. One example is controlling the movement of precursor chemicals used to produce illicit drugs such as methamphetamine. Mexico’s successful ban on methamphetamine precursors, combined with international interdiction efforts, has forced trafficking groups to seek new smuggling routes from as close as Belize to as far away as Argentina, pointing to the need for coordinated regional action.

State ---

6.1.C

Work With Partners in Europe, Africa, and Asia To Disrupt Drug Flows in the Trans-Atlantic and Trans-Pacific Regions

The United States, the North Atlantic Treaty Organization (NATO), and the European Union work closely on an array of counterdrug issues around the world.

Read more
This cooperation includes not only significant efforts in Afghanistan, but also assistance programs in Africa and other regions. Where it exists, the connection between drug trafficking and terrorism is a significant transnational threat that requires interagency and international collaboration in efforts to track and address the problem. During the past year, the International Security Assistance Force (ISAF) has implemented its new mandate that allows ISAF forces to participate in operations to break the narcotics-insurgency nexus in Afghanistan, which provides more than 90 percent of the world’s heroin and threatens Afghan economic and governance development and the stability of the broader region. European Union member states, including the United Kingdom, France, The Netherlands, and Spain, have long provided valuable maritime and aviation support to drug interdiction in the Western Hemisphere. These and other nations have joined together to establish the Maritime Analysis and Operations Centre-Narcotics (MAOC-N) in Portugal, which seeks to coordinate international interdiction activities for targeting cocaine flowing to Europe. United States officials use several mechanisms to coordinate counterdrug priorities with Europe, most notably through the biannual United States-European Union Troika meetings and bilateral discussions with United Kingdom counterparts on counternarcotics cooperation in Afghanistan. Since NATO, the European Union, and individual European nations provide significant amounts of foreign assistance in countries where the United States also has aid programs, the Department of State, USAID, and other agencies shall seek to intensify cooperation with international partners to optimize program impact and to avoid duplication. Such cooperation can be enhanced through exchanges such as the Trans-Pacific Symposium on Dismantling Transnational Illicit Networks hosted by the Departments of State and Homeland Security in the fall of 2009, which drew participants from more than 40 countries, jurisdictions, and organizations.

State ---

6.1.E

Expand Global Prevention and Treatment Initiatives Bilaterally and Through Cooperation With the United Nations, the Organization of American States, the Colombo Plan, and Other Multilateral Organizations

In spite of decades of research demonstrating the cost-effectiveness of drug treatment, the vast majority of countries lack sufficient infrastructure to provide quality treatment services to the millions of individuals in need.

Read more
As described previously, this gap is present in the United States but is all the more acute in less developed countries. Over the years, the United States has provided training and technical assistance in demand reduction through a range of international programs. These efforts must be expanded and better coordinated. Whenever possible, the United States will seek to partner with the UNODC and regional organizations such as the OAS and the Colombo Plan, which have begun to scale up treatment assistance through an array of programs. Provision of evidence-based and culturally sensitive training and technical assistance related to drug abuse prevention and treatment is a primary instrument of United States’ international demand reduction programs. The State Department will intensify its training and technical assistance programs, which combine didactic and experiential learning strategies and prioritize cultural competency. The State Department will also expand research and evaluation activities that are outcome/impact focused to improve program monitoring and effectiveness. Community anti-drug coalitions and network development will also be strengthened to foster exchange of information and collaboration. Another opportunity that will be pursued is to further emphasize drug treatment as part of the comprehensive, integrated HIV package of care and treatment services for people who use injection drugs. The program is funded around the world by the United States through the Office of the Global AIDS Coordinator (State/OGAC). Prevention programs would also benefit from increased technical cooperation and training coordinated by the State Department in cooperation with United States agencies and international partners. The State Department will continue to support global prevention and disseminate best practices.

State ---

6.2.A

Strengthen Strategic Partnerships With Mexico

Drug-trafficking organizations based largely in Mexico, but operating throughout the Western Hemisphere, have garnered huge financial returns from the illicit drug trade.

Read more
These trafficking groups engage in violence targeting both government forces and their rivals. The Government of Mexico has responded with tremendous resolve and commitment to directly counter drug-trafficking organizations. The United States, as the primary market for drugs transiting Mexico, must be a full partner in this effort. Achieving domestic drug use reduction goals listed earlier in this Strategy will help meet the United States’ responsibilities. In addition, the Strategy strongly supports the continuation of the Merida Initiative—primarily a United States-Mexico partnership initiated in 2007. This intensified bilateral collaboration incorporates an array of activities and programs, including the United States-Mexico Demand Reduction Bi-National Conference held on February 23–25, 2010, in Washington D.C., which fostered collaboration on prevention and treatment initiatives. As a result of the Merida Initiative, the United States and Mexico are engaged in unprecedented levels of two-way information sharing, collaboration on sensitive cases, and joint planning. Bilateral mechanisms already in place to address challenges such as weapons trafficking and bulk cash smuggling also will be used to dismantle the drug-trafficking organizations that continually exploit the border.

State ---

6.2.B

Disrupt the Narcotics-Insurgency Nexus and the Narcotics-Corruption Nexus in Afghanistan

Disrupting the illicit narcotics trade in Afghanistan is essential to ensuring Afghanistan’s future security, stability, and rule of law; depriving the Taliban of opium trade profits; and reducing the flow of illegal opiates to partner nations in Europe and Asia.

Read more
Limiting the pervasive impact that the narcotics-insurgency-corruption symbiosis has had on Afghan economic development, governance, and security, as well as on regional stability, is important to the United States’ national security interests. The United States is engaging in a new approach to counter opium poppy cultivation and heroin production and trafficking in Afghanistan. This approach is focused on fostering rural economic and agricultural development and enhanced interdiction to wean Afghan farmers off opium poppy while depriving the insurgency and corrupt officials of the profits from this illegal economy. The United States is also working with the Islamic Republic of Afghanistan to conduct investigations and operations in Afghanistan targeting drug kingpins and high-value targets, including organizations funding the insurgency. The United States will continue to work with its Afghan partners and other international allies and multilateral organizations such as UNODC that share a commitment to reducing opium poppy cultivation and heroin production in Afghanistan.

State ---

6.2.C

Build the Law Enforcement and Criminal Justice Capacities of Source Countries in the Western Hemisphere to Sustain Progress Against Illicit Drug Production and Trafficking

The United States has long cooperated with Colombia and Peru on interdiction, eradication, and alternative development programs, while helping to build critical capabilities within the security forces required to exercise state control in remote, under-governed areas where coca and poppy are cultivated and processed.

Read more
Colombia and Peru have experienced significant success (see update on Plan Colombia) due primarily to their own historic efforts, but assisted by resources and expertise provided by the United States. With the latest data showing a significant disruption of the cocaine market in the United States and a notable decrease in Andean coca and opium poppy cultivation, these successful efforts in reducing the production and trafficking of Andean cocaine must be maintained. Although United States interdiction programs with Bolivia have been largely suspended at the request of their government, the State Department is maintaining some alternative development efforts and remains open to resuming broader anti-drug cooperation at a later date.

State ---

6.2.D

Implement the Caribbean Basin Security Initiative

Central American and Caribbean nations are at great risk for drug trafficking, production, and abuse.

Read more
The United States, through Merida Initiative funding, is providing additional law enforcement training, equipment, and other assistance to Central American nations, Haiti, and the Dominican Republic. The Caribbean Basin Security Initiative (CBSI) will further strengthen the key institutions of our Caribbean partners to face the challenges of transnational crime and reduced economic opportunities. The United States is also working with partner nations to promote community-based policing and demand-reduction and anti-gang efforts. These efforts, combined with joint operations continually conducted by DEA, will provide an opportunity to reduce drug trafficking in these vital regions of the Western Hemisphere.

State ---

6.2.E

Promote Alternative Livelihoods for Coca and Opium Farmers

Drug-consuming nations face a responsibility to offer support and collaboration to nations struggling with challenges related to drug production and trafficking.

Read more
This aid shall include not only law enforcement, interdiction, and eradication aid, but also incentives to wean farmers away from illicit crop cultivation where security and natural agricultural capacity permit it. United States aid is provided to help ensure a viable, sustainable, licit alternative livelihood for these farmers. USAID will continue to support such programs, linking them with illicit crop reduction and working to partner with other donor nations.

State USAID

6.2.F

Support the Central American Regional Security Initiative

To sustain and expand on past United States programs for law enforcement, rule of law, human rights, and economic and social development initiated with Merida Initiative funding, the United States has established the Central American Regional Security Initiative (CARSI).

Read more
Participating countries include Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama. CARSI seeks to address the corrosive impact of narcotics and weapons trafficking, gangs, organized crime, porous borders, public safety, and rule of law issues that exist in many Central American countries. This initiative also facilitates further regional security cooperation among the Central American nations in coordination with the Merida Initiative and CBSI.

State ---

6.2.H

Consolidate the Gains Made in Colombia

Colombia and the United States have jointly made impressive gains over the past 10 years.

Read more
However, these gains are entirely reversible without continued United States support and sustained Colombian efforts. The United States will continue to support the Government of Colombia to stem the flow of drugs produced abroad and reduce the devastating consequences of drug production, trafficking, and consumption. As part of a multiyear strategy, the United States is transferring operational and funding responsibility for counternarcotics and security programs to the Colombian government as part of a larger multiyear strategy designed to consolidate state presence and economic development in historically marginalized regions. The expansion of security by both the Colombian military and police into areas long dominated by coca cultivation and illegal armed groups has allowed the Colombian government, for the first time, to focus on establishing government presence and integrated rural development in these areas. Voluntary and manual eradication will be emphasized, but aerial eradication will also remain an important tool, especially in remote and insecure areas where manual eradication is cost prohibitive or too dangerous. The United States Government continues to implement an integrated, sequential assistance approach designed to have a greater impact on consolidating the gains made in Colombia. Ultimately, the most effective way of reducing the production of illicit drugs is through the expansion of governance into conflict areas so that all Colombians have access to government services, protection from terrorist or criminal groups, and a licit manner in which to earn a living. This expansion of governance is the natural evolution of Plan Colombia efforts.

State ---

5.2.B

Develop National Deconfliction and Coordination Plan

Drug detection, monitoring, interdiction, and apprehension are divided into Source, Transit, and Arrival Zones.

Read more
United States anti-drug programs in the Source Zone are coordinated through U.S. Embassies within host nations, and the Transit Zone is coordinated by the Coast Guard-led Joint Interagency Task Force South (JIATF-S). In the Arrival Zone, although there is an extraordinary amount of effort by Federal, State, and local agencies, there is no comprehensive cross-cutting coordination mechanism. JIATF-S, widely recognized as the “gold standard” for Transit Zone intelligence fusion, information sharing, interagency coordination, and multinational partnering, should serve as a model for an Arrival Zone Task Force. The Interdiction Committee (TIC), chaired by the Coast Guard Commandant and chartered by ONDCP, is an interagency body that strategically coordinates supply reduction activities. For the past year, the TIC has been studying options to apply an operational model similar to JIATF-S to the Arrival Zone under the rubric of a National Task Force (NTF). The NTF, whether virtual in nature or concentrated within an existing multiagency coordination facility such as EPIC on the southwest border, would integrate multiple Federal coordination centers for air, land, and sea with regional and local intelligence and coordination centers to ensure near real-time dissemination of intelligence to task forces and agencies to support rapid facilitation of controlled deliveries or interdiction operations, as appropriate. Thus, TIC is directed to provide ONDCP with an update on the status of a National Arrival Zone Task Force implementation plan with full interagency and state and local participation by November 1, 2010.

TIC ---

6.3.C

Target the Illicit Finances of Drug-Trafficking Organizations

Profits are what drive the illegal drug trade and what tie drug trafficking to other transnational threats, including international organized crime and terrorism.

Read more
The United States must marshal its resources in a coordinated fashion to target illegal revenue streams of all kinds. The United States must also engage the international community in major anti-money-laundering and anti-cartel profit initiatives. Traffickers have updated their methods for moving money around the globe. They have turned to using stored value cards and other new mechanisms to evade law enforcement, but also rely on traditional money exchange systems while they continue to smuggle large amounts of bulk cash. International terrorist organizations often engage in drug-related money-laundering or cash-smuggling operations to generate funds for their operations. Thus, efforts to address illicit finance must include a focus on the drug-terror nexus. United States agencies have developed an array of techniques to target illicit finance. These efforts, which include regulatory initiatives and the highly effective targeted sanctions and financial enforcement actions led by the Treasury, must be further intensified and expanded. United States agencies should assess the current approach and look for opportunities to update and expand these efforts, including developing a comprehensive national threat finance plan of action.

Treasury ---

3.1.C

Expand the Innovations of the Department of Veterans Affairs Substance Use Disorder

The VA has made major advances in the care of veterans who have substance use disorders, including expanded addiction treatment, primary care-based screening and intervention, path-breaking research on psychosocial and medication-based treatments, and integration of addiction treatment-based information and services into the broader health care system.

Read more
  In addition to continuing to expand and improve its state-of-the-art system, VA will take an active role in sharing its knowledge and innovations with other Federal systems.  VA and DOD will continue to work collaboratively to develop evidence-based clinical practice guidelines for the treatment of substance use disorders and related conditions, and each agency will continue to fund research projects on the role of substance abuse, post-traumatic stress disorder (PTSD), and traumatic brain injury on the well-being of former (VA) and current (DOD) military personnel and their families.  Through its Centers for Excellence in Substance Abuse Treatment and Education, VA will also provide ongoing consultation to HRSA and IHS as they improve the integration of care for substance use disorders into the health care systems they oversee.

VA ---

4.2.H

Connect Incarcerated Veterans with Critical Substance Abuse and Reentry Services

Every year, approximately 40,000 Veterans are released from incarceration.

Read more
Many of these Veterans have significant substance abuse or mental health issues which, if left untreated, contribute to homelessness, further criminal behavior, and drastically reduce the likelihood for successful reentry into their community.

VA ---

ONDCP Strategy Appendix